title: Synchronous metastatic cutaneous squamous cell carcinoma and chronic lymphocytic leukaemia/small lymphocytic lymphoma in a cervical lymph node: Case report of an unusual event.
abstract: The synchronous occurrence of two different neoplasias is an uncommon event, which may arise between tumors originating in the same organ or in cancer-to-cancer metastasis. We report a rare case of chronic lymphocytic leukaemia / small lymphocytic lymphoma associated with a cutaneous metastatic squamous cell carcinoma in a cervical lymph node. In the affected lymph node, it was observed an effacement of the normal architecture by neoplastic lymphocytes and it was noted the presence of neoplastic invasive epithelial islands. Immunohistochemical analysis demonstrated that lymphocytic proliferation was positive for CD20, CD5, CD23 and Kappa, and negative for CD3, CD10, Cyclin D1 and Lambda. The morphological and immunohistochemical profile lead to a phenotype of B-cell chronic lymphocytic leukaemia / small lymphocytic lymphoma. The epithelial cells were positive for CK5, thus rendering the diagnosis of synchronous metastatic cutaneous squamous cell carcinoma and chronic lymphocytic leukaemia/small lymphocytic lymphoma. Literature supports the poor prognosis in cases that present coexistence of squamous cell carcinoma and chronic lymphocytic leukaemia / small lymphocytic lymphoma. Thus, it is necessary to be aware about this unusual finding in order to provide specific treatment.
  
  
  BACKGROUND
  Chronic lymphocytic leukaemia, small lymphocytic lymphoma, squamous cell carcinoma, metastasis.
authors.affiliation: DDS, MSc. Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, Piracicaba, Brazil.
authors.forename: Harim-Tavares
authors.initials: HT
authors.lastname: Dos Santos
authors.affiliation: DDS, PhD. Oral Pathology, School of Dentistry, Rio de Janeiro Federal University, Rio de Janeiro, Brazil.
authors.forename: Bruno-Augusto
authors.initials: BA
authors.lastname: Benevenuto
authors.affiliation: MD, Student. Department of Pathology, Medical Sciences Faculty, University of Campinas (UNICAMP), Tessália Vieira de Camargo, Campinas, Brazil.
authors.forename: Edson-Robles-Castilla
authors.initials: ER
authors.lastname: Filho
authors.affiliation: MD, PhD. Department of Pathology, Medical Sciences Faculty, University of Campinas (UNICAMP), Tessália Vieira de Camargo, Campinas, Brazil.
authors.forename: Albina
authors.initials: A
authors.lastname: Altemani