Squamous cell carcinoma of the uterine cervix in association with stage 0 chronic lymphocytic leukemia/small lymphocytic lymphoma
ABSTRACT There have been many cases of multiple malignant neoplasms involving the female genital tract reported, but involvement by epithelial and hematologic malignancy is extremely rare.
A 52-year-old woman, who was followed for stage 0 chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), had developed invasive squamous cell carcinoma of the uterine cervix. Microscopic examination of the hysterectomy specimen disclosed invasive squamous cell carcinoma in the cervix and monotonous populations of small lymphoid cells with proliferation centers, which are consistent with CLL/SLL, in the cervix as well as parametrium. Thirty months after the initial diagnosis of CLL/SLL, the patient died with systemic dissemination of squamous cell carcinoma, but the CLL/SLL remained a local disease.
The clinical course of squamous cell carcinoma in this case appeared to be aggressive, but it was unclear whether the outcome was associated with an altered immune status due to the presence of concurrent CLL/SLL.
SourceAvailable from: Amine Chakroun[Show abstract] [Hide abstract]
ABSTRACT: INTRODUCTION: The association of squamous cell carcinoma of the larynx and chronic lymphocytic leukemia (CLL) is exceptional. We report an observation of this association and present the therapeutic problems as well as the effects on prognosis. OBSERVATION: Direct laryngoscopy showed a tumor of the right hemilarynx, with the biopsy concluding in moderately differentiated keratinizing squamous cell carcinoma. The patient had a total laryngectomy, with bilateral lymph node evidement. The anatomopathological examination of the operative specimen demonstrated infiltration of the larynx and squamous cell carcinoma adenopathies and CLL. It was decided to monitor the chronic lymphoid leukemia, classified as Binet stage B. The synchronous or metachronous onset of a second cancer in a patient with CLL is more frequent than in the general population. The synchronous association of squamous cell carcinoma of the larynx and CLL has been described only rarely. The therapeutic strategy should focus first on the cancer with the shortest survival rate. The prognosis is more negative in an association of cervicofacial squamous cell carcinoma and leukemia than in a single cervicofacial cancer.European Annals of Otorhinolaryngology, Head and Neck Diseases 09/2010; 127(4):153-5. DOI:10.1016/j.anorl.2010.04.003
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ABSTRACT: Introduction L’association carcinome épidermoïde du larynx et leucémie lymphoïde chronique (LLC) est exceptionnelle. Nous rapportons une observation de cette association et présentons les difficultés thérapeutiques ainsi que le retentissement sur le pronostic. Discussion La laryngoscopie directe a montré une tumeur de l’hémilarynx droit dont la biopsie a conclu à un carcinome épidermoïde moyennement différencié kératinisant. Le patient a eu une laryngectomie totale, avec évidement ganglionnaire bilatéral. L’examen anatomopathologique de la pièce opératoire a objectivé une infiltration du larynx et des adénopathies par un carcinome épidermoïde et une LLC. Nous avons décidé de surveiller la LLC classée stade B de Binet. Conclusion La survenue d’un second cancer chez un patient atteint d’une LLC de façon synchrone ou métachrone est plus fréquente que dans la population générale. L’association synchrone d’un carcinome épidermoïde du larynx et d’une LLC a été rarement décrite. La stratégie thérapeutique doit se focaliser en premier sur le cancer ayant le plus faible taux de survie. Le pronostic est plus péjoratif lors d’une association carcinome épidermoide cervicofacial et leucémie qu’en cas de cancer cervicofacial unique.06/2010; 127(2):95-98. DOI:10.1016/j.aforl.2010.04.003
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ABSTRACT: CD5 expression is considered a key marker for the diagnosis of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). We report an unusual case of CD5-negative (CD5−) SLL with a concurrent CD5-positive (CD5+) adenocarcinoma of unknown primary involving the same lymph node. An 83-year-old woman with a history of CD5− B cell lymphoma diagnosed on a core biopsy of a cervical lymph node presented with jaundice and was found to have a 2.5-cm pancreatic mass. A fine needle aspiration of the mass revealed a CD5− monotypic B cell population. A subsequent excisional biopsy of a cervical lymph node showed morphologic findings typical for SLL, including the presence of multiple proliferation centers. However, the neoplastic lymphocytes were negative for CD5 by both flow cytometric analysis and immunohistochemistry. Interestingly, multifocal metastatic adenocarcinoma was identified and was positive for CD5. Lack of CD5 expression often leads to the exclusion of CLL/SLL, particularly in small biopsy samples. However, rare cases of CD5− CLL/SLL have been reported. In addition, CD5 is not an exclusive marker for lymphoid cells; its expression has been observed in several non-hematopoietic neoplasms. This report briefly reviewed and discussed CD5− CLL/SLL and CD5+ carcinoma reported in the literature.03/2012; 6(1). DOI:10.1007/s12308-012-0153-9