Abstract
Metastatic carcinoma to a lymph node with high grade lymphoma is very rare, particularly when high grade lymphoma is the first time diagnosis. Here we report a case where metastatic pancreatic ductal adenocarcinoma was found in a retroperitoneal lymph node with diffuse large B cell lymphoma (DLBCL). Histologically, the metastatic adenocarcinoma is located mainly in the subcapsular region. The lymph node architecture is diffusely effaced by proliferation of medium to large atypical lymphoid cells with prominent nucleoli, eosinophilic cytoplasm and eccentric nuclei. Immunohistochemical studies revealed these neoplastic lymphocytes are consistent with diffuse large B-cell lymphoma with immunoblastic morphology. Literatures on concomitant metastatic carcinoma with lymphoma in the same lymph node were reviewed. The significance and underline biological mechanisms were also discussed.
Highlights
The occurrence of multiple primary malignant tumors in the same individual is well reported [1,2], whereas coexistence of two malignancies in the same organ/site is uncommon [3,4]
The second malignancy may be unexpectedly discovered during the investigation for previous malignant tumor [5]
No treatment was given for diffuse large B cell lymphoma (DLBCL) post surgery
Summary
The occurrence of multiple primary malignant tumors in the same individual is well reported [1,2], whereas coexistence of two malignancies in the same organ/site is uncommon [3,4]. The second malignancy may be unexpectedly discovered during the investigation for previous malignant tumor [5]. It has been reported previously that patients with small cell lymphoma/chronic lymphocytic leukemia (SLL/CLL), have an increased risk of developing other malignancies, squamous-cell carcinoma [6,7,8]. Metastasis of adenocarcinoma to a lymph node harboring diffuse large B cell lymphoma (DLBCL) is extremely rare. We report a case that DLBCL was unexpectedly discovered in a patient’s retroperitoneal lymph node with metastatic moderately differentiated pancreatic ductal adenocarcinoma
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