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A Case of Rectal Carcinoma Complicated with Adult T-cell Leukemia/Lymphoma Diagnosed by an Inguinal Lymph Node Biopsy

Received: 21 May 2021     Accepted: 4 June 2021     Published: 15 June 2021
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Abstract

Background: Recently, double cancer is no longer uncommon. It is Particularly difficult to determine whether swollen lymph nodes (LNs) indicate malignant lymphoma or metastasis of other carcinoma. We experienced a case of rectal carcinoma complicated with adult T-cell leukemia/lymphoma (ATLL). Case presentation: We encountered a 77-year-old woman who had visited a previous hospital due to bloody stool. Colonoscopy revealed a 10-cm tumor in the lower rectum. Given its pit pattern and surface and vessel pattern, she was suspected of having adenocarcinoma in situ. However, enhanced computed tomography (CT) showed LN swelling around the rectum, and her bilateral inguinal LNs were palpable. Colonoscopy and a biopsy performed at our hospital showed adenoma (Group 3) with no malignant findings. We performed an inguinal LN biopsy and diagnosed her with ATLL. We suspected the rectal mass either be rectal carcinoma or ATLL invasion. We performed chemotherapy for ATLL. The inguinal LNs became no longer palpable, but the rectal mass did not shrink, so we performed operative resection for diagnostic treatment. Thereafter, we diagnosed her with double cancer of rectal adenocarcinoma and ATLL. Conclusion: It is difficult to determine whether swollen LNs indicate malignant lymphoma or metastasis of other carcinoma without performing an LN biopsy. However, a diagnosis of metastasis or non-metastasis does not influence either the staging of the carcinoma or the treatment plan.

Published in Journal of Surgery (Volume 9, Issue 4)
DOI 10.11648/j.js.20210904.14
Page(s) 166-169
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

ATLL, Rectal Adenocarcinoma, Double Cancer, Inguinal Lymph Node Biopsy

References
[1] Ministry of Health, HTLV-1 information service http://www.htlv1joho.org/general/general_htlv1.html Accessed 1 May 2020.
[2] The Japanese society of HTLV-1 and associated diseases http://htlv.umin.jp/shukai/20181110.html Accessed 1 May 2020.
[3] R. Koyama, S. Yoshida, S. Takanashi et al. “A case of multiple rectal cancer coexisting with malignant lymphoma” Journal of Japan Surgical Association 2014; 75 (3): 759-763.
[4] M. Amano, S. Maeda, J. Maeda et al. “A case of colon cancer associated with smoldering Adult T-Cell Leukemia” Journal of Japan Surgical Association 1990; 51 (6): 1312-1315.
[5] H. Imazu, T. Funabishi, M. Ochiai et al. “A case of Nodal malignant lymphoma at colectomy with lymph nodes dissection for acarcinoma of the descending colon” Journal of Japan Surgical Association 1998; 59 (6): 1592-1595.
[6] S. Sugihara, K. Teshima, E. Toyama et al. “Two case reports of malignant lymphoma at colectomy with lymph nodes dissection for colon cancer” Journal of Surgery 2005; 59 (12): 1879-1882.
[7] H. Nakatsumi, Y. Kawamoto, K. Etoh et al. “A case of Hodgkin lymphoma with multiple granulomatic disorders and S-coloneal carcinoma” Hakodate Medical Journal 2007; 31 (1): 8-11.
[8] T. Kobatake, Y. Kubo, K. Ohta et al. “A case of Ascending Colon Cancer which was Overdiagnosed by Preoperative FDG-PET/CT because of the Coexisting of Malignant Lymphoma” Journal of Japanese College of Surgeons 2008; 33 (2): 179-184.
[9] M. Kobayashi, M. Kaneshiro, K. Tamaguchi et al. “Double primary Malignant Tumor of Sigmoid Colon Adenocarcinoma and Hodgkin’s Lymphoma: A Case Report “Journal of Kurashiki Central Hospital 2011; 74: 225-229.
[10] T. Inoue, F. Okumura, T. Mizushima et al. “Difficult diagnoses of two cases of double cancer involving malignant lymphoma with peritoneal localization and malignant abdominal tumor” Journal of Gastroenterology 2014; 111 (12): 2295-2302.
[11] M. Yamauchi, Y. Shimada, T. Fujimoto et al. “A case of double cancer of Cecal carcinoma and Hodgkin’s lymphoma” The Japanese Journal of Clinical and Experimental Medicine 2018; 95 (4): 427-430.
[12] Y. Takamori, M. Yokote, Y. Kuyama et al. “A case of Colonic Cancer in ATL (Adult T-cell Leukemia)” Progress of digestive endoscopy 1993; 42: 285-288.
[13] M. Tani, H. Tsubakihara, K. Noguchi et al. “Adult T-Cell Leukemia Associated with Gastric Carcinoma: Report of a Case” Surgery Today 2001; 31: 233-237.
[14] Iris Uribesalgo, Cecilia Ballare, Luciano Di Croce et al. “Polycomb Regulates NF-κB Signaling in Cancer through miRNA” Cancer Cell 2012: 5-7.
[15] Mohamed Mahgoub, Jun-ichirou Tasunaga et al. “Sporadic on/off switching of HTLV-1 Tax expression is crucial to maintain the whole population of virus-induced leukemic cells” Proceedings of the National Academy of Sciences of the United States of America 2018; 115 (6): E1269-E1278.
[16] A. Utsunomiya, S. Hanada “Clinical and pathological features of gastrointestinal lesions in patients with Adult T cell leukemia” Journal of Clinical and Experimental Hematopathology 1990; 30 (5): 401-418.
[17] N. Yamaguchi, H. Isomoto, K. Ohnita et al. “HTLV-1 and Lower Gastrointestinal Tract Lesions” Stomach and intestine 2011; 46 (3): 275-281.
Cite This Article
  • APA Style

    Mai Kuwahara, Takashi Goto, Shintaro Yamamoto, Takanobu Sugase, Naoki Inadome, et al. (2021). A Case of Rectal Carcinoma Complicated with Adult T-cell Leukemia/Lymphoma Diagnosed by an Inguinal Lymph Node Biopsy. Journal of Surgery, 9(4), 166-169. https://doi.org/10.11648/j.js.20210904.14

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    ACS Style

    Mai Kuwahara; Takashi Goto; Shintaro Yamamoto; Takanobu Sugase; Naoki Inadome, et al. A Case of Rectal Carcinoma Complicated with Adult T-cell Leukemia/Lymphoma Diagnosed by an Inguinal Lymph Node Biopsy. J. Surg. 2021, 9(4), 166-169. doi: 10.11648/j.js.20210904.14

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    AMA Style

    Mai Kuwahara, Takashi Goto, Shintaro Yamamoto, Takanobu Sugase, Naoki Inadome, et al. A Case of Rectal Carcinoma Complicated with Adult T-cell Leukemia/Lymphoma Diagnosed by an Inguinal Lymph Node Biopsy. J Surg. 2021;9(4):166-169. doi: 10.11648/j.js.20210904.14

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  • @article{10.11648/j.js.20210904.14,
      author = {Mai Kuwahara and Takashi Goto and Shintaro Yamamoto and Takanobu Sugase and Naoki Inadome and Hiroshi Hojo and Kazuhiko Ibusuki and Shoji Taniguchi and Hiroshi Kawano and Hiroshi Tai and Keiko Umekita and Hiroyuki Tanaka and Rintaro Koga},
      title = {A Case of Rectal Carcinoma Complicated with Adult T-cell Leukemia/Lymphoma Diagnosed by an Inguinal Lymph Node Biopsy},
      journal = {Journal of Surgery},
      volume = {9},
      number = {4},
      pages = {166-169},
      doi = {10.11648/j.js.20210904.14},
      url = {https://doi.org/10.11648/j.js.20210904.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20210904.14},
      abstract = {Background: Recently, double cancer is no longer uncommon. It is Particularly difficult to determine whether swollen lymph nodes (LNs) indicate malignant lymphoma or metastasis of other carcinoma. We experienced a case of rectal carcinoma complicated with adult T-cell leukemia/lymphoma (ATLL). Case presentation: We encountered a 77-year-old woman who had visited a previous hospital due to bloody stool. Colonoscopy revealed a 10-cm tumor in the lower rectum. Given its pit pattern and surface and vessel pattern, she was suspected of having adenocarcinoma in situ. However, enhanced computed tomography (CT) showed LN swelling around the rectum, and her bilateral inguinal LNs were palpable. Colonoscopy and a biopsy performed at our hospital showed adenoma (Group 3) with no malignant findings. We performed an inguinal LN biopsy and diagnosed her with ATLL. We suspected the rectal mass either be rectal carcinoma or ATLL invasion. We performed chemotherapy for ATLL. The inguinal LNs became no longer palpable, but the rectal mass did not shrink, so we performed operative resection for diagnostic treatment. Thereafter, we diagnosed her with double cancer of rectal adenocarcinoma and ATLL. Conclusion: It is difficult to determine whether swollen LNs indicate malignant lymphoma or metastasis of other carcinoma without performing an LN biopsy. However, a diagnosis of metastasis or non-metastasis does not influence either the staging of the carcinoma or the treatment plan.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - A Case of Rectal Carcinoma Complicated with Adult T-cell Leukemia/Lymphoma Diagnosed by an Inguinal Lymph Node Biopsy
    AU  - Mai Kuwahara
    AU  - Takashi Goto
    AU  - Shintaro Yamamoto
    AU  - Takanobu Sugase
    AU  - Naoki Inadome
    AU  - Hiroshi Hojo
    AU  - Kazuhiko Ibusuki
    AU  - Shoji Taniguchi
    AU  - Hiroshi Kawano
    AU  - Hiroshi Tai
    AU  - Keiko Umekita
    AU  - Hiroyuki Tanaka
    AU  - Rintaro Koga
    Y1  - 2021/06/15
    PY  - 2021
    N1  - https://doi.org/10.11648/j.js.20210904.14
    DO  - 10.11648/j.js.20210904.14
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 166
    EP  - 169
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20210904.14
    AB  - Background: Recently, double cancer is no longer uncommon. It is Particularly difficult to determine whether swollen lymph nodes (LNs) indicate malignant lymphoma or metastasis of other carcinoma. We experienced a case of rectal carcinoma complicated with adult T-cell leukemia/lymphoma (ATLL). Case presentation: We encountered a 77-year-old woman who had visited a previous hospital due to bloody stool. Colonoscopy revealed a 10-cm tumor in the lower rectum. Given its pit pattern and surface and vessel pattern, she was suspected of having adenocarcinoma in situ. However, enhanced computed tomography (CT) showed LN swelling around the rectum, and her bilateral inguinal LNs were palpable. Colonoscopy and a biopsy performed at our hospital showed adenoma (Group 3) with no malignant findings. We performed an inguinal LN biopsy and diagnosed her with ATLL. We suspected the rectal mass either be rectal carcinoma or ATLL invasion. We performed chemotherapy for ATLL. The inguinal LNs became no longer palpable, but the rectal mass did not shrink, so we performed operative resection for diagnostic treatment. Thereafter, we diagnosed her with double cancer of rectal adenocarcinoma and ATLL. Conclusion: It is difficult to determine whether swollen LNs indicate malignant lymphoma or metastasis of other carcinoma without performing an LN biopsy. However, a diagnosis of metastasis or non-metastasis does not influence either the staging of the carcinoma or the treatment plan.
    VL  - 9
    IS  - 4
    ER  - 

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Author Information
  • Department of Surgery, Koga General Hospital, Miyazaki, Japan

  • Department of Surgery, Koga General Hospital, Miyazaki, Japan

  • Department of Surgery, Koga General Hospital, Miyazaki, Japan

  • Department of Surgery, Koga General Hospital, Miyazaki, Japan

  • Department of Surgery, Koga General Hospital, Miyazaki, Japan

  • Department of Surgery, Koga General Hospital, Miyazaki, Japan

  • Department of Surgery, Koga General Hospital, Miyazaki, Japan

  • Department of Surgery, Koga General Hospital, Miyazaki, Japan

  • Department of Hematology, Koga General Hospital, Miyazaki, Japan

  • Department of Gastroenterology, Koga General Hospital, Miyazaki, Japan

  • Department of Pathology, University of Miyazaki Hospital, Miyazaki, Japan

  • Department of Pathology, University of Miyazaki Hospital, Miyazaki, Japan

  • Department of Surgery, Koga General Hospital, Miyazaki, Japan

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