Features and approaches to treating patients with concurrent lung cancer and lymphoproliferative disorders
Yu. V. Perminov,
A. O. Nefedov,
M. M. Mortada,
G. G. Kudryashov,
E. M. Kyzylova,
O. V. Khodyreva,
P. K. Yablonskiy https://doi.org/10.21294/1814-4861-2025-24-4-162-169
Abstract
Background. Epidemiological studies show that the incidence of synchronous multiple primary malignant neoplasms ranges from 2 % to 17 %. the co-occurrence of lung cancer and lymphoma accounts for 15 % of all combinations of lymphoproliferative diseases with malignant neoplasms of other organs. Currently, there is no universally accepted diagnostic and treatment strategy for this patient group.
Objective: To present a series of clinical cases demonstrating the significance of a personalized approach in the diagnosis and treatment of patients with the concurrent diagnosis of lung cancer and lymphoproliferative diseases.
Case reports. We report two cases of synchronous lung cancer and B-cell lymphoma. In both cases, diagnosis of multiple primary malignancies guided optimal treatment strategies.
Conclusion. Lung cancer should be included in the differential diagnosis of pulmonary lesions in patients with chronic leukemia or lymphoma. a thorough examination and morphological verification of the identified changes in this group of patients will help to choose the correct treatment strategy.
About the Authors
Yu. V. Perminov
Saint Petersburg State Research Institute of Phthisiopulmonology, Ministry of Health of Russia
Russian Federation
Russian Federation
Yuriy V. Perminov, MD, Oncologist, Thoracic Surgeon
2–4, Ligovsky ave., Saint Petersburg, 191036
A. O. Nefedov
Saint Petersburg State Research Institute of Phthisiopulmonology, Ministry of Health of Russia
Russian Federation
Russian Federation
Andrei O. Nefedov, MD, PhD, Senior Researcher, Head of the Department of Thoracic Oncology
2–4, Ligovsky ave., Saint Petersburg, 191036
M. M. Mortada
Saint Petersburg State Research Institute of Phthisiopulmonology, Ministry of Health of Russia
Russian Federation
Russian Federation
Makhmud M. Mortada, MD, Oncologist, Thoracic Surgeon
2–4, Ligovsky ave., Saint Petersburg, 191036
G. G. Kudryashov
Saint Petersburg State Research Institute of Phthisiopulmonology, Ministry of Health of Russia
Russian Federation
Russian Federation
Grigoriy G. Kudryashov, MD, PhD, Leading Researcher, Head of the Department of Pulmonology and Thoracic Surgery Center, Thoracic Surgeon of the highest category
2–4, Ligovsky ave., Saint Petersburg, 191036
E. M. Kyzylova
Saint Petersburg State Research Institute of Phthisiopulmonology, Ministry of Health of Russia
Russian Federation
Russian Federation
Ekaterina M. Kyzylova, MD, Oncologist, Thoracic Surgeon; Assistant Professor, Department of Hospital Surgery, Faculty of Medicine
2–4, Ligovsky ave., Saint Petersburg, 191036
O. V. Khodyreva
Saint Petersburg State Research Institute of Phthisiopulmonology, Ministry of Health of Russia
Russian Federation
Russian Federation
Olga V. Khodyreva, MD, Anatomic Pathologist of the first category, Department of Pathological Anatomy
2–4, Ligovsky ave., Saint Petersburg, 191036
P. K. Yablonskiy
Saint Petersburg State Research Institute of Phthisiopulmonology, Ministry of Health of Russia ; Saint Petersburg State University
Russian Federation
Russian Federation
Petr K. Yablonskiy, MD, DSc, Professor; Vice-Rector, Professor, Department of Hospital Surgery, Faculty of Medicine
2–4, Ligovsky ave., Saint Petersburg, 191036
7–9, Universitetskaya emb., Saint Petersburg, 199034
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Supplementary files
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1. Fig. 1. PET/CT scan with 18F-FDG (lesion of the lower jaw, cervical lymph nodes on the right, upper lobe of the left lung in large B-cell lymphoma). Note: created by the authors | |
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2. Fig. 2. PET/CT with 18F-FDG (leveling of the formation of the buccal region on the right with signs of reparative processes of the mandible, decreased metabolic activity of the lymph nodes of the neck, accumulation of RFP in the projection of the formation of the apex of the left lung). Note: created by the authors | |
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3. Fig. 3. MSCT of the chest organs (hypovascular solid formation with spicules in the projection of the apex of the left lung, widely adjacent to the pleura). Note: created by the authors | |
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4. Fig. 4. Microphoto. Mucinous adenocarcinoma of the upper lobe of the left lung: 4.1 – positive adenocarcinoma staining at Sc7, ×200; 4.2 – CDX2 tumor cell staining, ×200. Note: created by the authors | |
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5. Fig. 5. MSCT of the thoracic cavity organs (on the left in the upper lobe, a solid-type formation with a bumpy contour, measuring 15×14 mm, density +18HU, with a density gradient when contrasting +20+25HU). Note: created by the authors | |
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6. Fig. 6. MSCT of the thoracic cavity (lymphoproliferative process involving intrathoracic, axillary, cervical, intra-abdominal and retroperitoneal lymph nodes, pelvic nodes, hepatosplenomegaly). Note: created by the authors | |
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7. Fig. 7. Microphoto. Squamous cell carcinoma: 7.1 – large polygonal cells with a wide eosinophilic cytoplasm, polymorphic nuclei, and prominent intercellular bridges. Frozen slice. Hematoxylin-eosinophilic staining, ×400; 7.2 – tumor cells express p63, ×200. Note: created by the authors | |
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8. Fig. 8. Microphoto. Chronic lymphocytic leukemia/small lymphocyte lymphoma: 8.1 – an intrathoracic lymph node with a complete loss of architectonics, diffuse infiltration by a relatively monomorphic population of lymphocytes. Hematoxylin-eosin staining, ×200; 8.2 – the population of tumor cells is represented by lymphocytes with scanty cytoplasm, among which there are cells with oval nuclei, centrally located nucleoli (paraimmunoblasts). Hematoxylin-eosin staining, ×400; 8.3 – tumor cells express CD20, an increase х200; 8.4 – CD5 expression, ×200; 8.5 – staining of the B cell membrane on CD 23, ×400. Note: created by the authors | |
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For citations:
Perminov Yu.V., Nefedov A.O., Mortada M.M., Kudryashov G.G., Kyzylova E.M., Khodyreva O.V., Yablonskiy P.K. Features and approaches to treating patients with concurrent lung cancer and lymphoproliferative disorders. Siberian journal of oncology. 2025;24(4):162-169. (In Russ.) https://doi.org/10.21294/1814-4861-2025-24-4-162-169
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