Korean J Hematol.  2009 Sep;44(3):133-138. 10.5045/kjh.2009.44.3.133.

A Case of Chronic Lymphocytic Leukemia Coexisting with Basal Cell Carcinoma and Lung Cancer

• Kim DK
• Park JC
• Choi WH
• Kim JH
• Han CW

• KMID: 2252130
• DOI: http://doi.org/10.5045/kjh.2009.44.3.133

Abstract

Chronic lymphocytic leukemia (CLL) can be characterized by the accumulation of small mature lymphocytes in the peripheral blood, bone marrow and other lymphoid tissues. It is well known that the risk of secondary malignancy is high in patients with CLL. A secondary malignancy in a patient with CLL may influence the prognosis as well as the treatment of CLL. As CLL is a rare disease in Korea, there have been only a few reported Korean cases of CLL with secondary malignancy. We experienced the case of a 73-year-old man who suffered from CLL with basal cell carcinoma of the skin and non-small cell lung cancer. At first, he presented with excessive lymphocytosis (>100,000/mm3), anemia, thrombocytopenia and splenomegaly, and he was diagnosed with CLL according to the bone marrow biopsy. Simultaneously he had basal cell carcinoma on his face. Seven months later, he began to feel chest discomfort and his chest X-ray showed a mass like lesion on the left upper lung. It was proven to be non-small cell lung cancer by bronchoscopic biopsy.

Keyword

Chronic lymphocytic leukemia; Basal cell carcinoma; Lung cancer

MeSH Terms

Aged
Anemia
Biopsy
Bone Marrow
Carcinoma, Basal Cell
Carcinoma, Non-Small-Cell Lung
Humans
Korea
Leukemia, Lymphocytic, Chronic, B-Cell
Lung
Lung Neoplasms
Lymphocytes
Lymphocytosis
Lymphoid Tissue
Prognosis
Rare Diseases
Skin
Splenomegaly
Thorax
Thrombocytopenia

Figure

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  Fig. 1. (A) The patient has diffuse sclerotic brownish patch with a firm nodule on the left face. (B) The microscopic findings of a nodular lesion show that tumor cells with pleomorphic, hyperchromatic and oval nuclei are seen budding from the undersurface of the epidermis (H&E stain, ×200).

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  Fig. 2. At the time of diagnosis of CLL, the chest x-ray shows subtle fibrotic scars in left upper lung field (A). And after 7 months of diagnosis of CLL, the chest x-ray shows a large mass in the left upper lung field with broad base in the mediastinum (B).

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  Fig. 3. The chest CT shows that a large mass with multiple nonenhancing areas in the left upper lobe is in contact with left pulmonary artery.

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  Fig. 4. In the PET CT, there is an increased FDG uptake at the left upper lobe mass (SUV=8.8; arrow) shown in chest CT (A) and there are multinodular increased FDG activities at left pleura (SUV=5.4 and 4.1, respectively; two arrows) (B).

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  Fig. 5. The microscopic findings show that tumor cells are compsed of pleomorphic epithelial cells with keratinization which are features of squamous differentiation (H&E stain,×200).

Reference

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