Non-Hodgkin Lymphoma Secondary to Cancer Chemotherapy in a Patient with Small Cell Carcinoma of the Pancreas


Increased survival seen in patients with solid cancers achieved through aggressive treatment has transformed the prognosis and the complications of the therapy. The carcinogenic effect of the therapeutical agents has given leads to an increased incidence of second malignancies. This case report describes the rare metachronous association of two malignancies and to discuss the etiological links. A 51-year-old man presented with enlargement of right axilla and mesentery lymph nodes. The patient had a history of small cell carcinoma at the head of the pancreas and was treated with chemotherapy cisplatin and gemcitabine for 12 cycles two years prior. Biopsies were then performed. Diagnosis of Non-Hodgkin Lymphoma (NHL) follicular (nodular) type was decided from microscopic and immunohistochemistry results. We discussed that secondary NHL due to chemotherapy for solid cancer is rare. Testicular cancer, ovarian cancer, and breast cancer are the common primary tumors. The primary tumor from a small cell carcinoma of the pancreas (SCCP) is sporadic. The risk of
secondary lymphoma increases after the first five years of completion of chemotherapy or radiotherapy and persists for more than three decades. In conclusion, this case reinforces the need for long-term follow-up of all patients exposed to chemotherapy for the treatment of pancreatic cancer.

Keywords: Secondary NHL, chemotherapy, small cell carcinoma of the pancreas

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