Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Oct 15, 2017; 9(10): 431-435
Published online Oct 15, 2017. doi: 10.4251/wjgo.v9.i10.431
Primary esophageal diffuse large B cell lymphoma presenting with tracheoesophageal fistula: A rare case and review
Jirapat Teerakanok, Judy Park DeWitt, Edna Juarez, Kyaw Zin Thein, Irfan Warraich
Jirapat Teerakanok, Edna Juarez, Kyaw Zin Thein, Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, United States
Judy Park DeWitt, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, United States
Irfan Warraich, Department of Pathology, Texas Tech University Health Sciences Center, Lubbock, TX 79430, United States
Author contributions: Teerakanok J and DeWitt JP contributed equally to this work and should be considered as co-first authors; Teerakanok J and DeWitt JP researched and reviewed literatures, wrote manuscript; Juarez E collected patient’s data; Thein KZ reviewed and wrote manuscript; Warraich I reviewed tissues pathology and conducted critical review.
Institutional review board statement: This case report does not require Texas Tech University Health Sciences Center IRB review.
Informed consent statement: Patient’s legal guardian provided verbal informed consent authorizing discloses and use his information.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Irfan Warraich, MD, Department of Pathology, Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX 79430, United States.
Telephone: +1-806-7432155
Received: February 21, 2017
Peer-review started: February 23, 2017
First decision: May 7, 2017
Revised: May 30, 2017
Accepted: July 14, 2017
Article in press: July 17, 2017
Published online: October 15, 2017

Primary non-Hodgkin lymphomas in the esophagus are rare. Tracheoesophageal fistulas mainly arise from solid esophageal carcinoma or mediastinal malignancies. Our patient presented with cough, dysphagia and weight loss, and upon initial computed tomography imaging and esophagogastroduodenoscopy, a malignant mass in the middle third of esophagus with tracheoesophageal fistula was found. The location of the mass and presence of malignant tracheoesophageal fistula were strongly suggestive of squamous cell carcinoma. However, tumor biopsy revealed diffuse large B-cell lymphoma. This case report details a rare incident of a primary diffuse large B-cell lymphoma presented as tracheoesophageal fistula and reviews previous literature.

Keywords: Non-Hodgkin lymphoma, Tracheoesophageal fistula, Esophageal cancer, Esophageal lymphoma

Core tip: Primary non-Hodgkin lymphoma of esophagus is a rare disease, and tracheoesophageal fistula secondary to this condition prior to treatment is extremely rare and fatal. However, it has better prognosis than fistulas secondary to solid tumor if patients receive timely treatment.