Adult T-Cell Leukemia Associated with Gastric Carcinoma: Report of a Case

Abstract

A 67-year-old man was admitted to our hospital with nausea and epigastralgia, and a diagnosis of smoldering type adult T-cell leukemia (ATL) associated with advanced gastric carcinoma was made. The gastric carcinoma had caused pyloric stenosis, and investigations revealed regional lymph node metastasis. The patient underwent total gastrectomy, splenectomy, cholecystectomy, and lymph node dissection with a Roux-en-Y anastomosis. Histological examination of the regional lymph nodes revealed not only metastases of gastric carcinoma, but also of ATL lymphoma, indicating a final diagnosis of advanced gastric carcinoma with locoregional lymph node due to both metastasis of the gastric carcinoma and the ATL lymphoma. Despite the administration of postoperative adjuvant chemotherapy comprised of cisplatin/adriamycin/5-fluorouracil in combination with oral etoposide and immunotherapy using ubenimex, paraplegia suddenly developed caused by the metastasis of ATL to the epidural space. Resection of this metastatic tumor for decompression of the spinal cord resulted in resolution of the paraplegia; however, the patient died about 1 month later from rapid systemic tumor growth.

Mantle Cell Lymphoma in Lymph Nodes with Metastatic Small Cell Carcinoma of Lung: A Diagnostic and Treatment Dilemma

“…A similar situation has been reported by Tani et al [26], in which a gastric carcinoma was found metastatic to gastric lymph nodes with synchronous adult T-cell leukemia/lymphoma (ATL). ATL is also a highergrade malignancy than CLL/SLL and FL.…”

Acute Myelogenous Leukemia Suddenly Developing Just After Surgery for Advanced Gastric Cancer: Report of a Case

“…Many reports on therapy-related leukemias mention chromosomal anomalies, 15 but no decisive factors have yet been determined. 16 Future progress in genomic analysis will probably contribute to more effective strategies for the differential diagnosis of this unusual disease.…”

Tumor de colisión: Metástasis de adenocarcinoma y linfoma folicular en un mismo ganglio linfático

“…Por otro lado, la coexistencia de un carcinoma y un linfoma afectando a un mismo ganglio linfático, como en el caso que presentamos, es rara 4,[16][17][18][19][20][21][22][23][24][25][26][27][28][29] . La revisión de la literatura demuestra que la neoplasia primaria en estos casos también suele ser un linfoma de bajo grado (linfoma folicular o leucemia linfática crónica/linfoma linfocítico de células pequeñas) que generalmente ha sido diagnosticado años antes de que aparezca la neoplasia epitelial.…”

“…La revisión de la literatura demuestra que la neoplasia primaria en estos casos también suele ser un linfoma de bajo grado (linfoma folicular o leucemia linfática crónica/linfoma linfocítico de células pequeñas) que generalmente ha sido diagnosticado años antes de que aparezca la neoplasia epitelial. Con menos frecuencia se han descrito linfomas de alto grado (linfoma del manto, leucemia prolinfocítica y linfoma de células T) [27][28][29] . Probablemente el curso relativamente indolente de los linfomas de bajo grado garantiza una expectativa de vida suficiente para que se desarrolle una segunda neoplasia de tipo epitelial 28 .…”