Synchronous and Metachronous Malignant Epithelial and Lymphoid Tumors: a Clinicopathologic Study of 10 Patients from a Major Tertiary Care Center in Pakistan

Our plain-English summary of Synchronous and Metachronous Malignant Epithelial and Lymphoid Tumors: a Clinicopathologic Study of 10 Patients from a Major Tertiary Care Center in Pakistan, by N. Ud Din, Z. Ahmad, K. Minhas, et al (Asian Pacific Journal of Cancer Prevention, 2017).

The study

• Authors: N. Ud Din, Z. Ahmad, K. Minhas, Z. Uddin, A. Ahmed
• Journal: Asian Pacific Journal of Cancer Prevention
• Published: 2017;18(8):2067-2072
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Case reports and case series documenting unfortunate patients with more than one malignant neoplasm are rare but well established. While majority of such patients have two malignancies, cases with three or even four malignant neoplasms in the same patient have been published in literature. A number of factors influencing carcinogenesis have been implicated in such cases including exposure to large amounts of radiation, chemotherapy for the original malignancy; prolonged history of heavy smoking and exposure to other environmental carcinogens; aging; and underlying genetic alterations. Concomitant multiple malignant neoplasms may be synchronous-two or more malignant neoplasms histologically distinct from each other, arising in the same site and detected simultaneously (for example during the same hospital admission) or detected one after the other in sequence in a period less than 6 months; or metachronous-two or more malignant neoplasms of similar or distinct histologic type detected at different times (after an interval of greater than 6 months) in different anatomic sites. Any combination of malignant tumors can occur in the same patient for example carcinomas with other carcinomas, carcinomas with Non-Hodgkin or Hodgkin lymphomas, carcinomas with mesotheliomas, carcinomas with sarcomas etc. We have reported several cases with multiple malignancies during our practice, and these cases were composed of the different combinations described above. The aim of the present study is to document 10 such cases of combined carcinoma and Non Hodgkin lymphoma in the same patient which were diagnosed in our section.

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In plain English

This article was a case series from the Section of Histopathology at Aga Khan University Hospital in Karachi, Pakistan. The authors reviewed pathology slides and records of 10 patients who each had both a carcinoma and a non-Hodgkin lymphoma. Seven patients were male and three were female, aged 14 to 81 years. Five cases were synchronous (the cancers were found at or near the same time) and five were metachronous (found more than six months apart). Three cases involved the colon, two the breast, and one the kidney; none involved the stomach. Follow-up was available for 8 of the 10 patients. The text reported 5 of these alive and 3 dead of their disease. The study did not examine asbestos exposure and included no mesothelioma cases. Asbestos appeared only in the discussion, which cited other published case reports of lung adenocarcinoma and mesothelioma occurring together in asbestos-exposed people. The authors did not state a separate formal conclusion or list limitations.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case series (clinicopathologic review of surgical pathology files)
• Who was studied: 10 patients with both a carcinoma and a non-Hodgkin lymphoma, diagnosed at Aga Khan University Hospital, Karachi, Pakistan. The table lists biopsies and resections from 2008 to 2016.
• Exposure: No exposure was studied. Asbestos is mentioned only in the discussion, in reference to other published case reports, not to any patient in this series.
• Main results:
  • Of the 10 patients, 7 (70%) were male and 3 (30%) were female.
  • Ages ranged from 14 to 81 years, with a mean of 60.8 years and a median of 62 years.
  • 5 of 10 cases (50%) were synchronous and 5 (50%) were metachronous.
  • Follow-up was available for 8 of 10 patients. The text states that 5 of these 8 were alive and 3 had died of their disease.
  • None of the 10 cases involved the stomach, while 3 of the 10 involved the colon.
  • Both patients with breast carcinoma developed low-grade B cell nodal marginal zone lymphoma.
  • One patient had renal cell carcinoma together with diffuse large B cell lymphoma (DLBCL).
• The authors' conclusion: The article does not state a separate conclusion. Its stated aim was to document these 10 cases.

Topics

Medical terms in this study, explained in our Lexicon: Neoplasm, Carcinogenesis, Chemotherapy, Carcinoma, Mesothelioma, Sarcoma.

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