Lung cancer and concurrent or sequential lymphoma: Two case reports with hypersensitivity to bevacizumab and a review of the literature

Abstract

Non-small cell lung cancer (NSCLC) accounts for ~80% of all cases of lung cancer, and is the leading cause of cancer-related mortality worldwide. The majority of NSCLC cases of are diagnosed at an advanced stage. The outcome of patients with advanced NSCLC is poor with a median survival time of ~12 months in European and American populations. Lymphoproliferative disorders (LPDs) represent a heterogeneous group of expanding lymphoid cells, which occurs as a result of immune dysfunction. LPDs are often associated with primary solid cancers. We report two cases of LPD diagnosed concurrently and successively to NSCLC. The first case presents a 65-year-old female patient with advanced IV stage lung cancer, according to the International Association for the Study of Lung Cancer TNM staging system. The patient developed a concurrent lymphoma and was treated with first-line therapy including six cycles of gemcitabine and cisplatin, however, the patient experienced an adverse drug reaction to bevacizumab, which was administered after gemcitabine and prior to cisplatin. The second case presented a 74-year-old male patient diagnosed with large B cell lymphoma. The patient acheived remission of the illness, however, after one year the patient was diagnosed with squamous cell lung cancer. After three years, the patient underwent surgery, however disease recurrence was identified. Subsequently, the patient was treated with sterotactic radiotherapy and oral chemotherapy. A review of the associated literature was also conducted.

One Pulmonary Lesion, 2 Synchronous Malignancies

“…Authors have proposed certain mechanisms such as the possible spread of cancerous cells from a single clone to multiple sites, 19 genetic defects involving mismatch repair systems, 20 a positive family history of malignancy, 8 and/or a complex interplay of genetics, impaired immunity, viremia (ie, Epstein-Barr virus, etc), and carcinogenic risk factors (such as smoking) that ultimately all contribute to the development of synchronous multiple primary cancers. 5 It is plausible that both complex genetics and history of smoking placed our patient at risk for these 2 tumors.…”

“… 4 Lymphomas and leukemias tend to be among the most common neoplasms involved even as subsequent neoplasms, and usually arise within the first 5 years. 5 Solid tumors are more common after 5 years, with breast and lung cancer being the most frequent. 6 In a review of 77 823 patients, Tward et al demonstrated that NHL survivors have an absolute excess cancer risk of 6.36 times (in men) and 7.10 times (in women) for a second primary lung and/or mediastinal tumor, specifically.…”

Network pharmacology and bioinformatics were used to construct a prognostic model and immunoassay of core target genes in the combination of quercetin and kaempferol in the treatment of colorectal cancer

“…It can also inhibit tumor growth by inhibiting angiogenesis [87] or inhibit cell proliferation by inducing autophagy of tumor cells, such as human glioma cells, primary lymphoma cells, ovarian cancer cells, human leukemia cells, etc., such as [88][89][90]. Cancer cell metastasis is associated with cell migration and invasion and is a major cause of death and poor prognosis in patients [91]. Studies have shown that quercetin can bate the migration and invasion of rectal carcinoma and head and neck squamous cell carcinoma [92][93], lung cancer cells [94], pancreatic cancer cells [95], melanoma cells [96], thereby preventing the metastasis of cancer cells.…”

Synchronous primary pulmonary adenocarcinoma and extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue

“…[ 24 ] Fourthly, carcinogenic risk factors (e.g., smoking and aging) may ultimately trigger in the pathogenesis of multiple primary cancers synchronously. [ 25 ] Finally, the synchronous onset of 2 different malignancies in the same site was a random coincidence, which showed no specific relations among these lesions. [ 13 ]…”