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Abstract：
Nasopharyngeal carcinoma (NPC) is more common in men aged 40 to 59, and radiotherapy is an effective treatment. Nasopharyngeal lymphoma (NPL) is rare, and the coexistence of nasopharyngeal mantle cell lymphoma (MCL) and NPC is even rarer. A collision tumor is a rare type of tumor that refers to two or more different tumors occurring in the same organ. No reports to date have described a collision tumor of NPC and MCL occurring within the same nasopharyngeal mass. We herein report the successful treatment of a unique case of synchronous coexistence of NPC and MCL occurring in the nasopharynx of a Chinese man.
A 58-year-old man presented with a 5-month history of swallowing discomfort. Biopsy was performed under nasopharyngeal endoscopy, and histopathology revealed NPC. Magnetic resonance imaging revealed lesions in the nasopharynx, oropharynx, and tonsils, as well as enlarged lymph nodes in the parotid gland, posterior ear, and neck. This may be a synchronous dual primary tumor coexisting with NPC and NPL. Pathology consultation confirmed that the biopsy specimen of the nasopharynx was a collision tumor of NPC and MCL. Positron emission tomography computed tomography (PET-CT) revealed thickening of the posterior wall of the nasopharynx, which was considered NPC with lymphoma. The enlargement of the pharyngeal lymph ring and multiple hypermetabolic lymph nodes were evaluated as lymphoma infiltration. The patient received two courses of R-CHOP chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) followed by head and neck radiotherapy. At the time of this writing, he had remained alive without recurrence for 61 months since the initial treatment and was still undergoing follow-up.
It is very important to correctly recognize collision tumors. Magnetic resonance imaging helps identify different components of collision tumors. Pathological examination helps to confirm the diagnosis. Histological examination reveals different components, and PET-CT can help determine the extent of the lesion. Dose-adjusted chemotherapy combined with radiotherapy may have promising herapeutic effects, but additional case studies are needed to confirm.
A 58-year-old man presented with a 5-month history of swallowing discomfort. Biopsy was performed under nasopharyngeal endoscopy, and histopathology revealed NPC. Magnetic resonance imaging revealed lesions in the nasopharynx, oropharynx, and tonsils, as well as enlarged lymph nodes in the parotid gland, posterior ear, and neck. This may be a synchronous dual primary tumor coexisting with NPC and NPL. Pathology consultation confirmed that the biopsy specimen of the nasopharynx was a collision tumor of NPC and MCL. Positron emission tomography computed tomography (PET-CT) revealed thickening of the posterior wall of the nasopharynx, which was considered NPC with lymphoma. The enlargement of the pharyngeal lymph ring and multiple hypermetabolic lymph nodes were evaluated as lymphoma infiltration. The patient received two courses of R-CHOP chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) followed by head and neck radiotherapy. At the time of this writing, he had remained alive without recurrence for 61 months since the initial treatment and was still undergoing follow-up.
It is very important to correctly recognize collision tumors. Magnetic resonance imaging helps identify different components of collision tumors. Pathological examination helps to confirm the diagnosis. Histological examination reveals different components, and PET-CT can help determine the extent of the lesion. Dose-adjusted chemotherapy combined with radiotherapy may have promising herapeutic effects, but additional case studies are needed to confirm.
摘要：
背景：鼻咽癌（NPC）在40至59岁的男性中更为常见，放射治疗是一种有效的治疗方法。鼻咽淋巴瘤（NPL）是罕见的，鼻咽套细胞淋巴瘤（MCL）和NPC的共存更为罕见。碰撞肿瘤是一种罕见类型的肿瘤，是指在同一器官中发生的两个或多个不同的肿瘤。迄今为止，尚无报道描述在同一鼻咽肿块内发生的NPC和MCL的碰撞肿瘤。我们在此报告了成功治疗中国人鼻咽中发生的NPC和MCL同步共存的独特病例。
方法：一名58岁的男性，有5个月的吞咽不适病史。在鼻咽内镜下进行活检，组织病理学显示NPC。磁共振成像显示鼻咽部病变，口咽,和扁桃体,以及腮腺淋巴结肿大，后耳,和脖子。这可能是与NPC和NPL共存的同步双原发肿瘤。病理会诊证实鼻咽部活检标本为NPC与MCL碰撞瘤。正电子发射断层扫描计算机断层扫描（PET-CT）显示鼻咽后壁增厚，这被认为是NPC与淋巴瘤。咽部淋巴结肿大和多个高代谢淋巴结被评估为淋巴瘤浸润。患者接受了两个疗程的R-CHOP化疗（利妥昔单抗，环磷酰胺,阿霉素,长春新碱,和泼尼松），然后进行头颈部放疗。在撰写本文时，自初次治疗以来，他一直存活61个月，没有复发，并且仍在接受随访。
结论：正确识别碰撞肿瘤非常重要。磁共振成像有助于识别碰撞肿瘤的不同成分。病理检查有助于明确诊断。组织学检查揭示了不同的成分，PET-CT可以帮助确定病变的范围。剂量调整化疗联合放疗可能有很好的治疗效果。但需要更多的案例研究来证实。
方法：一名58岁的男性，有5个月的吞咽不适病史。在鼻咽内镜下进行活检，组织病理学显示NPC。磁共振成像显示鼻咽部病变，口咽,和扁桃体,以及腮腺淋巴结肿大，后耳,和脖子。这可能是与NPC和NPL共存的同步双原发肿瘤。病理会诊证实鼻咽部活检标本为NPC与MCL碰撞瘤。正电子发射断层扫描计算机断层扫描（PET-CT）显示鼻咽后壁增厚，这被认为是NPC与淋巴瘤。咽部淋巴结肿大和多个高代谢淋巴结被评估为淋巴瘤浸润。患者接受了两个疗程的R-CHOP化疗（利妥昔单抗，环磷酰胺,阿霉素,长春新碱,和泼尼松），然后进行头颈部放疗。在撰写本文时，自初次治疗以来，他一直存活61个月，没有复发，并且仍在接受随访。
结论：正确识别碰撞肿瘤非常重要。磁共振成像有助于识别碰撞肿瘤的不同成分。病理检查有助于明确诊断。组织学检查揭示了不同的成分，PET-CT可以帮助确定病变的范围。剂量调整化疗联合放疗可能有很好的治疗效果。但需要更多的案例研究来证实。
