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Case Reports
. 2024 Apr 29;16(2):260-269.
doi: 10.3390/hematolrep16020026.

Is There an Association between a Tonsillar Diffuse Large B-Cell Lymphoma Arising after a Neck Squamous Cell Carcinoma of Occult Primary? A Case Report and Extensive Literature Review

Dimitris Tatsis  1 , Athena Niakou  1 , Konstantinos Paraskevopoulos  1 , Stavroula Papadopoulou  1 , Konstantinos Vahtsevanos  1
Affiliations
Case Reports

Is There an Association between a Tonsillar Diffuse Large B-Cell Lymphoma Arising after a Neck Squamous Cell Carcinoma of Occult Primary? A Case Report and Extensive Literature Review

Dimitris Tatsis et al. Hematol Rep. .

Abstract

Objectives: The aim of this review is to focus on the possibility of patients with squamous cell carcinoma to develop a second primary disease such as DLBCL, perhaps because of the irradiation of the head and neck area.

Materials and methods: A case of an 89-year-old man is reported, who initially underwent surgical and complementary treatment for neck squamous cell carcinoma of occult primary and later for tonsillar diffuse large B-cell non-Hodgkin lymphoma.

Results: The second primary was considered a recurrence in the neck of the original cancer of unknown primary, so a new surgical management was decided. The final pathology report described a diffuse large B-cell non-Hodgkin lymphoma.

Conclusions: The importance of maintaining follow-ups for patients with occult primary cancers who are at an elevated risk of developing a metastasis or a second primary carcinoma outbreak is highlighted.

Keywords: diffuse large B-cell lymphoma (DLBCL); squamous cell carcinoma (SCC); tonsillar.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
CT imaging of the initial neck mass. A: anterior, P: posterior, R: right, L: left, S: superior.
Figure 2
Figure 2
(A) CT, (B) MRI, and (C) PET-CT of the second primary disease on the contralateral neck. (A: anterior, P: posterior, R: right, L: left, S: superior.) The avidity in the image 2C depicts the two areas where the disease is evident in the PET-CT.
Figure 2
Figure 2
(A) CT, (B) MRI, and (C) PET-CT of the second primary disease on the contralateral neck. (A: anterior, P: posterior, R: right, L: left, S: superior.) The avidity in the image 2C depicts the two areas where the disease is evident in the PET-CT.
Figure 3
Figure 3
Histological examination of the second primary disease (tonsillar tissue). (A) Squamous cells without dysplasia, malignant neoplastic process with lymphoid character, H/E ×100. (B) CK5/6, no dysplasia evident, ×200. (C) Lymphoid characters with multiple forms and nuclear lesions, H/E ×400. (D) CD20, ×400. B-cell orientation, large lymphoid cells are observed, ×400. (E) CD79a, ×400. (F) BCL-2 stain, ×400.
See this image and copyright information in PMC

References

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