Collision tumor of pulmonary adenocarcinoma and small lymphocytic lymphoma - A rare case of concurrent malignancies in the same lymph node

Sep 21, 2026

Uploaded by Levi

Collision tumors are rare and diagnostically challenging entities defined by the simultaneous presence of two distinct histological neoplasms within the same anatomical site. The mechanisms remain unclear, and several hypotheses have been proposed. A 77-year-old Palestinian heavy smoker with comorbidities presented with productive cough and major weight loss, with CT showing extensive lung involvement, mediastinal lymphadenopathy, and adrenal nodules. Excisional lymph node biopsy confirmed both metastatic pulmonary adenocarcinoma and small lymphocytic lymphoma via histopathology and immunohistochemistry.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages7

Reading Time18 min

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Abstract

Introduction

Case presentation

International Journal of Surgery Case Reports 123 (2024) 110230 Contents lists available at ScienceDirect International Journal of Surgery Case Reports journal [homepage:](homepage: www.elsevier.com/locate/ijscr)[ www.elsevier.com/locate/ijscr](homepage: www.elsevier.com/locate/ijscr) | Case report
Collision tumor of pulmonary adenocarcinoma and small lymphocytic lymphoma: A rare case of concurrent malignancies in the same lymph node
Maaweya Jabareena,*, Abdalqader Aljaradata, Motaz Natshehb, Yousef Abu Asbehb, Hobaib Shawar b
a Faculty of Medicine, Hebron University, Hebron, Palestine b Al-Ahli hospital, Hebron, Palestine | | | | --- | --- | --- | | A R T I C L E I N F O | | A B S T R A C T | | Keywords:
Collision tumor
Pulmonary adenocarcinoma Small lymphocytic lymphoma Lymphangitis carcinomatosis Case report | | Background: Collision tumors, a rare and challenging diagnostic entity, are characterized by the simultaneous presence of two distinct histological neoplasms within the same anatomical site. The underlying mechanisms of collision tumors are not well understood, though various theories attempt to explain this phenomenon.
Case presentation: A 77-year-old Palestinian man, a heavy smoker with multiple comorbidities, presented with a productive cough and significant weight loss. Computed tomography (CT) scan with IV contrast revealed extensive pulmonary involvement, mediastinal lymphadenopathy, and adrenal gland nodules. An excisional biopsy of a lymph node confirmed the presence of both metastatic pulmonary adenocarcinoma and small Lymphocytic Lymphoma (SLL) through histopathological and immunohistochemical analyses.
Discussion: Collision tumors have been documented in various anatomical sites, such as the lung, gastrointestinal tract, skin, and genitourinary system. However, their occurrence in lymph nodes is exceptionally rare. Additionally, to our knowledge, a collision tumor involving both pulmonary adenocarcinoma and small lymphocytic lymphoma within the same lymph node has not been previously reported.
Conclusion: Collision tumors are uncommon and should be considered in the differential diagnosis of complex oncological cases. Accurate diagnosis requires comprehensive investigations, including imaging studies and detailed pathological examinations. | 1. Introduction This work has been reported in line with the SCARE criteria [1]. Collision tumors, characterized by the coexistence of two distinct histological neoplasms within the same anatomical site, a rare and challenging diagnostic entity in clinical practice. These tumors are marked by their unique histopathological features, where two different types of cancerous growths manifest independently within a shared tissue or organ without intermingling at the cellular level [2–3]. The phenomenon of collision tumors remains poorly understood, and several hypotheses have been proposed to explain their occurrence. These include the “random collision effect,” where two independent neoplastic clones arise coincidentally within close proximity, and the“field cancerization” theory, which suggests that a common carcinogenic environment predisposes adjacent tissues to develop distinct neoplasms. Another proposed mechanism is “tumor-to-tumor carcinogenesis,” where one tumor influences the growth and development of a second neoplasm in its vicinity [4]. In recent literature, collision tumors have been reported in various anatomical sites, including the lung, gastrointestinal tract, skin and genitourinary system. However, their occurrence in lymph nodes remains exceptionally rare, particularly when involving metastatic adenocarcinoma from the lung and primary lymphoid malignancies [3]. We present a rare case of a collision tumor composed of metastatic adenocarcinoma and small lymphocytic lymphoma diagnosed and managed at a private healthcare center. This unique combination of two distinct neoplasms within the same anatomical site

FAQs

What is a collision tumor in this case report?

A collision tumor involves two distinct histological neoplasms occurring at the same anatomical site. In this report, both were found within the same lymph node without cellular intermingling at the microscopic level.

What symptoms and imaging findings were reported?

The patient had productive cough and significant weight loss. CT with IV contrast showed extensive pulmonary involvement, mediastinal lymphadenopathy, and adrenal gland nodules.

How was the diagnosis of both cancers confirmed?

Diagnosis was confirmed by excisional biopsy of a lymph node. Histopathological and immunohistochemical analyses identified metastatic pulmonary adenocarcinoma and small lymphocytic lymphoma.

Sep 21, 2026

Uploaded by Levi