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Vol.57 No.6 contents | Japanese/English |
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- Case Report -
A Case of Mantle Cell Lymphoma That Was Difficult to Distinguish from a Relapse of Pulmonary Pleomorphic Carcinoma After Surgery
Shinichi Takeda1, Haruhiro Saito1, Yasushi Ishiyama2, Hiroyuki Ito1, Tomoyuki Yokose3, Kouzo Yamada11Department of Thoracic Oncology, 2Department of Medical Oncology, 3Department of Pathology, Kanagawa Cancer Center, Japan
Background. Pulmonary pleomorphic carcinoma is a rare form of lung cancer and there are few reports on the characteristics of its postoperative recurrence. We herein report our experience regarding a case in which lymphoma developed following lung cancer surgery, which was difficult to differentiate from a recurrence of lung cancer. Case. The subject was a 71-year-old man. He underwent surgical resection due to cancer in the upper-right lobe of the lung. The pathological diagnosis was pleomorphic carcinoma consisting of adenocarcinoma and spindle cell carcinoma (stage IIB, pT3N0M0). At one year after surgery, multiple lymphadenopathy was detected in the cervical/thoracoabdominal region by FDG-PET/CT. We suspected a postoperative recurrence of lung cancer and performed aspiration biopsy cytology on samples from the mediastinal and cervical lymph nodes; however, no such diagnosis was obtained. Subsequently, the emergence of atypical lymphocytes was observed in the peripheral blood; thus, a bone marrow biopsy was conducted. The immunohistological findings revealed aggregates of small cells that were CD5 (+), CD19 (+), CD20 (+), cyclin-D1 (+), and CD10 (-), and FISH revealed IGH/CCDN1 fusion gene positivity, resulting in a diagnosis of mantle cell lymphoma. R-CHOP therapy was conducted after diagnosis and the size of the lymph nodes was reduced. Conclusion. We conducted a close inspection to investigate multiple lymphadenopathy, which developed after surgery for pulmonary pleomorphic carcinoma, under the suspicion of a postoperative recurrence of lung cancer; however, it was difficult to make a diagnosis. Eventually, a bone marrow biopsy contributed to making a diagnosis of malignant lymphoma, and enabled the provision of appropriate treatment.
key words: Lung pleomorphic carcinoma, Relapse, Malignant lymphoma
Received: December 9, 2016
Accepted: July 10, 2017
JJLC 57 (6): 763-768, 2017
