title: Synchronous mantle cell lymph node lymphoma and pulmonary adenocarcinoma: a case report with literature review.
abstract: OBJECTIVE
  Coexistence of mantle cell lymphoma and lung adenocarcinoma is extremely rare. The aim of this study is to present the first case of incidental discovery of primary lung adenocarcinoma associated to lymph node mantle cell lymphoma.
  
  
  METHODS
  A 45 year-old man, admitted for inguinal mass appeared since three months. Physical examination showed a 1 cm axillary and 3 cm inguinal adenopathies which were hard and fixed. A biopsy of inguinal mass revealed mantle cell lymphoma. Assessment of disease extension found a right superior lobe tumor with mediastinal lymphadenopathies. Fibreoptic bronchoscopy was normal. A fine needle biopsy of lung tumor was performed to determinate the nature of the pulmonary lesion. Histopathological findings were consistent with primary poor differentiated pulmonary adenocarcinoma with TTF-1 expression. A first mediastinoscopy was realized to verify mediastinal lymphadenopathies; frozen section showed a mantle cell lymphoma. A right lobectomy was then performed confirming the diagnosis of lung adenocarcinoma. Then, the patient was treated for the mantle cell lymphoma by 6 cures of alternating RCHOP and RDHAP (dexamethasone, high-dose Ara-Cytarabine and cisplatin) regimens followed by autologous stem cell transplantation.
  
  
  RESULTS
  The patient died because of treatment complications 3 years after diagnosis.
  
  
  CONCLUSIONS
  Progresses are necessary to understand the pathogenesis of of synchronous occurrence of both diseases.
authors.affiliation: Department of Pathology, Abderrahmen Mami Hospital, Ariana, Tunisia.
authors.forename: Emna
authors.initials: E
authors.lastname: Braham
authors.affiliation: Department of Pneumology, Abderrahmen Mami Hospital, Ariana, Tunisia.
authors.forename: Mourad
authors.initials: M
authors.lastname: Zarrouk
authors.affiliation: Department of Pathology, Abderrahmen Mami Hospital, Ariana, Tunisia.
authors.forename: Mouna
authors.initials: M
authors.lastname: Mlika
authors.affiliation: Department of Thoracic Surgery, Abderrahmen Mami Hospital, Ariana, Tunisia.
authors.forename: Tarek
authors.initials: T
authors.lastname: Kilani
authors.affiliation: Department of Pathology, Abderrahmen Mami Hospital, Ariana, Tunisia.
authors.forename: Faouzi
authors.initials: F
authors.lastname: El Mezni
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000473:pathology; D000077192:Adenocarcinoma of Lung; D004358:Drug Therapy / Q000379:methods; D017809:Fatal Outcome; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D033162:Incidental Findings; D008168:Lung / Q000473:pathology* / Q000601:surgery; D008175:Lung Neoplasms / Q000150:complications* / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology*; D020522:Lymphoma, Mantle-Cell / Q000150:complications* / Q000473:pathology; D008297:Male; D008481:Mediastinoscopy; D008875:Middle Aged
keywords: adenocarcinoma - mantle cell lymphoma - pathology