Metastasis of lymph nodes melanoma with chronic lymphocytic leukemia/ small lymphocytic lymphoma: case report

Dragan Zivojinovic ,
Dragan Zivojinovic

Military Academy, Institute of Pathology and Foresnic Medicine , Belgrade , Serbia

Olga Radic-Tasic ,
Olga Radic-Tasic

Military Academy, Institute of Pathology and Foresnic Medicine , Belgrade , Serbia

Sasa Ristic ,
Sasa Ristic

Military Academy, Institute of Pathology and Foresnic Medicine , Belgrade , Serbia

Olivera Tarabar ,
Olivera Tarabar

Military Academy, Institute of Pathology and Foresnic Medicine , Belgrade , Serbia

Zoran Mirkovic ,
Zoran Mirkovic

Military Academy, Institute of Pathology and Foresnic Medicine , Belgrade , Serbia

Milica Rajovic
Milica Rajovic

Military Academy, Institute of Pathology and Foresnic Medicine , Belgrade , Serbia

Published: 01.04.2018.

Volume 34, Issue 1 (2018)

pp. 67-68;

Abstract

Aim: Purpose of this report is to present metastasis of lymph nodes melanoma with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) as an example of collision tumor of an uncommon synchronic occurrence in the lymph node. Introduction: Synchronic, composite tumors are rare and their simultaneous and synchronic occurence within the same tissue/organ is even more rare. CLL/SLL is an indolent, clonal disease of mature B-lymphocytes which occurs mostly with adults. After the treatment with chemotherapeutic agents the occurence of the secondary malignancies (melanoma,squamous-cell carcinoma). Material and Methods: We present a 77 year old male who, after right sided nephrectomy caused by clear-cell carcinoma was diagnosed with CLL/SLL with bone marrow and lymph node infiltration. After three years and chemotherapy, skin changes were excised which histomorphologically resembles melanoma. After the immunotherapy for melanoma, the enlarged lymph nodes were extripated from the neck and histomorphologically and immunohistochemically treated. Results: Histomorphologically, a diffused infiltration of small B-lymphocytes was found in the lymph node, with round nuclei, condensed chromatin, inconspicuous nucleoli, scant cytoplasm unique immunophenotype: CD20 ,PAX-5 ,CD5 ,CD23 ,Cyclin D1-,CD3-. A part of lymph node was infiltrated by epitheloid cells with immunohistochemic profile: S-100 ,Melan A ,HMB-45 . Histomorphological and immunohistochemical CLL/SLL with melanoma infiltration as an example of a collision tumor was proved. Conclusion: Lymphoproliferative neoplasms including CLL/SLL represent an risk of synchronous, metachronous development of secondary malignancies including melanoma itself and they can uncommonly present themselves as synchronic collision tumors within the same organ.

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