Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2023; 11(26): 6289-6297
Published online Sep 16, 2023. doi: 10.12998/wjcc.v11.i26.6289
Collision tumor of primary malignant lymphoma and adenocarcinoma in the colon diagnosed by molecular pathology: A case report and literature review
Meng Jiang, Xiao-Ping Yuan
Meng Jiang, School of Medicine, Sun Yat-sen University, Shenzhen 518107, Guangdong Province, China
Xiao-Ping Yuan, Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China
Author contributions: All the authors contributed to manuscript writing and editing, and data collection; Jiang M performed statistical analysis and drafted the manuscript; Yuan XP performed the literature review and revised the manuscript; All authors have read and approved the final manuscript.
Supported by National College Students Innovation and Entrepreneurship Training Program, No. 202110558154; College Students Innovation and Entrepreneurship Training Program of Sun Yat-sen University, No. 202211534; and No. 202311516.
Informed consent statement: Informed written consent was obtained from her family members to publish this case report and any accompanying images.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Ping Yuan, MD, Director, Doctor, Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang West Road, Guangzhou 510120, Guangdong Province, China. yuanxp@mail.sysu.edu.cn
Received: June 17, 2023
Peer-review started: June 17, 2023
First decision: August 4, 2023
Revised: August 15, 2023
Accepted: August 21, 2023
Article in press: August 21, 2023
Published online: September 16, 2023
Abstract
BACKGROUND

Collision tumors of primary malignant lymphoma and adenocarcinoma in the colon are rare. Primary diffuse large B-cell lymphoma (DLBCL)–adenocarcinoma collision tumors are especially rare.

CASE SUMMARY

A 74-year-old woman presented with abdominal pain of 1 mo duration. Biopsy under colonoscopy revealed adenocarcinoma of the ascending colon. Subsequently, the patient underwent laparoscopic radical resection of right colon cancer with lymph node dissection. A collision tumor was found incidentally through postoperative pathological sampling. Genetic analysis showed a collision tumor of DLBCL with germinal center B-cell subtype and TP53 mutation, and adenocarcinoma arising in a tubulovillous adenoma in the colon, with BRAF mutation and mutL homolog 1 promoter methylation. The patient died 3 mo after surgery. To our knowledge, this is the 23rd reported case of collision tumor of colorectal adenocarcinoma and lymphoma. The mean age of the 23 patients was 73 years. The most common site was the cecum. There were 15 cases with follow-up data including 11 living and four dead with a 3-year overall survival rate of 71.5%.

CONCLUSION

Based on pathological and genetic analysis, surgery combined with chemotherapy or chemoradiotherapy may have good therapeutic effects for collision tumor.

Keywords: Collision tumor, Colorectal adenocarcinoma, Primary colonic lymphoma, Molecular pathological analysis, Case report

Core Tip: Coexisting of primary diffuse large B-cell lymphoma (DLBCL) and adenocarcinoma in the colon are extremely rare. Here, we report a case of collision tumor of primary DLBCL, not otherwise specified with germinal center B-cell subtype and TP53 mutation, and adenocarcinoma arising in a tubulovillous adenoma in the colon, with BRAF mutation and mutL homolog 1 promoter methylation. Definite diagnosis is usually difficult until pathological confirmation. Based on pathological examination and genetic analysis, surgery combined with dose-adjusted chemotherapy or chemoradiotherapy may have good therapeutic effects.