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

Dong Kyu Kim; Ji Chan Park; Woo Hyung Choi; Ji Hee Kim; Chi Wha Han

doi:10.5045/kjh.2009.44.3.133

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Kim, Park, Choi, Kim, and Han: A Case of Chronic Lymphocytic Leukemia Coexisting with Basal Cell Carcinoma and Lung Cancer

Case Report

Korean J Hematol 2009;44(3):133-138.

Published online: 20 June 2009

DOI: https://doi.org/10.5045/kjh.2009.44.3.133

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

Dong Kyu Kim, M.D., Ji Chan Park, M.D., Woo Hyung Choi, M.D., Ji Hee Kim, M.D., Chi Wha Han, M.D.

Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea

Correspondence to：Chi Wha Han, M.D. Department of Internal Medicine, College of Medicine, The Catholic University of Korea 665-8, Bupyeong-dong, Bupyeong-Gu, Incheon 403-720, Korea Tel: ＋82-32-510-5507, Fax: ＋82-32-510-5054 E-mail: cwhan@unitel.co.kr

Received 30 April 2009 Revised 21 July 2009 Accepted 21 July 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Chronic lymphocytic leukemia, Basal cell carcinoma, Lung cancer

References

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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).

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).

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.

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).

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).

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