Composite Lymphoma in a Patient with Ulcerative Colitis: A Case Report
,
Abstract
A 45-year-old female patient with a diagnosis of ulcerative colitis complicated with composite lymphoma in the spleen and para-aortic lymph node presented with a one-month history of malaise, weakness and fatigue. Only mesalamine kept ulcerative colitis under control. In physical examination, splenomegaly was revealed and pancytopenia was obtained from laboratory data. Computed tomography scan revealed para-aortic mediastinal lymphadenopathy with splenomegaly. Splenectomy and excisional biopsy of abdominal lymph node were performed and disease was diagnosed as composite lymphoma, consisting of diffuse large B-cell lymphoma and nodular sclerosing Hodgkin lymphoma.
Bargen JA. Chronic ulcerative colitis associated with malignant disease. Dis Colon Rectum.1994; 37:727-30.
Thirumala S, Esposito M, Fuchs A. An unusual variant of composite lymphoma: a short case report and review of the literature. Arch Pathol Lab Med. 2000, 124:1376-8.
Kim H. Composite lymphoma and related disorders. Am J Clin Pathol.1993; 99:445-51.
Kim H, Hendrickson R, Dorfman RF. Composite lymphoma. Cancer. 1977; 40:959-76.
Dargent JL, Lespagnard L, Meiers I, Bradstreet C, Heimann P, De Wolf- Peeters C. Composite follicular lymphoma and nodular lymphocyte predominance Hodgkin’s disease. Virchows Arch. 2005; 447:778-80.
Caleo A, Sánchez A, Rodríguez S, Dotor AM, Beltrán L, de Larrinoa AF, etal.Composite Hodgkin lymphoma and mantle cell lymphoma: two clonally unrelated tumors. Am J SurgPathol .2003; 27:1577-80.
Kaleem Z, McGuire MH, Caracioni AC, Leonard RL, Pathan MH, Lessmann EA, et al. Composite B-cell and T-cell non-Hodgkin lymphoma of the tibia. Am J ClinPathol .2005; 123:215-21.
Cho JH.The genetics and immunopathogenesis of inflammatory bowel disease. Nat Rev Immunol. 2008; 8:458-66.
VosAC.Risk of malignant lymphoma in patients with inflammatory bowel diseases: a Dutch nationwide study. Inflamm Bowel Dis. 2011; 17: 1837-45.
Ashworth LA, Billett A, Mitchell P, Nuti F, Siegel C, Bousvaros A. Lymphoma risk in children and young adults with inflammatoryboweldisease: analysis of a large single-center cohort. Inflamm Bowel Dis.2012; 18: 838-43.
Chiorean MV, Pokhrel B, Adabala J, Helper DJ, Johnson CS, JuliarB.Incidence and risk factors for lymphoma in a single-center inflammatory bowel disease population.Dig Dis Sci .2011; 56: 1489-95.
Beaugerie L, Brousse N, Bouvier AM, Colombel JF, Lemann M, Cosnes J, et al. Lymphoproliferative
disorders in patients receiving thiopurines for inflammatory bowel disease: a prospective observational cohort study. Lancet .2009; 374:1617-25.
Lewis JD, Schwartz JS, Lichtenstein GR. Azathioprine for maintenance of remission in Crohn’s disease: benefits outweigh the risk of lymphoma. Gastroenterology.2000; 118:1018-24.
Dayharsh GA, Loftus EV Jr, Sandborn WJ, Tremaine WJ, Zinsmeister AR, Witzig TE, et al. Epstein-Barr virus-positive lymphoma in patients with inflammatory bowel disease treated with azathioprine or 6-mercaptopurine. Gastroenterology.2002; 122:72-77.
Beaugerie L, Seksik P, Carrat, F. Thiopurine therapy is associated with a threefold decrease in the incidence of advanced neoplaisa in IBD patients with longstanding extensive colitis: the CESAME prospective data. Journal of Crohn's and Colitis.2009
Mariette X, Cazals-Hatem D, Warszawki J, Liote F, Balandraud N, Sibilia J. Lymphomas in rheumatoid arthritis patients treated with methotrexate: a 3-year prospective study in France. Blood.2002; 99:3909-15.
Wolfe F, Michaud K. The effect of methotrexate and anti-tumor necrosis factor therapy on the risk of lymphoma in rheumatoid arthritis in 19,562 patients during 89,710 person-years of observation. Arthritis Rheum. 2007; 56:1433-9.
Siegel CA, Marden SM, Persing SM, Larson RJ, Sands BE. Risk of lymphoma associated with combination anti-tumor necrosis factor and immunomodulatortherapy for the treatment of Crohn’s disease: a meta-analysis. ClinGastroenterolHepatol. 2009; 7:874-81.
| Files | ||
| Issue | Vol 8, No 4 (2014) | |
| Section | Articles | |
| Keywords | ||
| Composite lymphoma Diffuse large B-Cell lymphoma Inflammatory bowel disease Nodular sclerosing Hodgkin lymphoma Ulcerative colitis | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
