A Collision of Diseases: Chronic Lymphocytic Leukemia Discovered During Lymph Node Biopsy for Melanoma
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
In the United States in 2012, there were 16,060 new cases of chronic lymphocytic leukemia (CLL). Often CLL is clinically occult and first detected during pathologic evaluation of the sentinel lymph node biopsy (SLNB). We reviewed our experience of patients with the coexisting diagnosis of melanoma and CLL.
An institutional review board-approved review was performed on patients with CLL and melanoma treated from 1995 to 2009 at Moffitt Cancer Center and compared with the incidence of melanoma and CLL in our tumor registry patients with breast, prostate, lung, and colon cancer.
Fifty-two patients (44 males; median age, 71 years [range, 46–88]) were identified with concurrent diagnoses of melanoma and CLL. Twenty-two patients (42 %) had CLL on SLNB for their melanoma. Thirty-two patients (62 %) were diagnosed with melanoma before CLL. Concomitant or prior cancer diagnoses included nonmelanoma skin cancers (N = 29), prostate (N = 6), colorectal (N = 2), and Merkel cell carcinoma (N = 2). Five of 20 patients (25 %) had metastatic melanoma found at the time of SLNB. Patients with melanoma had a tenfold increase of CLL diagnosis compared with colorectal cancer patients, an eightfold increase compared to prostate cancer patients, and a fourfold increase compared with breast cancer patients.
We have confirmed an increased association of CLL and melanoma. This may be related to an underlying immunologic defect; however, there has been scant investigation into this phenomenon. Surgeons and pathologists should understand this occurrence and recognize that not all grossly enlarged or abnormal sentinel lymph nodes in melanoma patients represent melanoma.
- Siegel R, Desantis C, Virgo K, et al. Cancer treatment and survivorship statistics, 2012. CA Cancer J Clin. 2012;62(4):220–41. CrossRef
- Cahill RA, McGreal G, Neary P, Redmond HP. Synchronous high-risk melanoma and lymphoid neoplasia. Melanoma Res. 2001;11(5):517–22. CrossRef
- Manusow D, Weinerman BH. Subsequent neoplasia in chronic lymphocytic leukemia. JAMA. 1975;232(3):267–9. CrossRef
- Greene MH, Hoover RN, Fraumeni JF Jr. Subsequent cancer in patients with chronic lymphocytic leukemia: a possible immunologic mechanism. J Natl Cancer Inst. 1978;61(2):337–40.
- Royle JA, Baade PD, Joske D, Girschik J, Fritschi L. Second cancer incidence and cancer mortality among chronic lymphocytic leukaemia patients: a population-based study. Br J Cancer. 2011;105(7):1076–81. CrossRef
- Verwer N, Murali R, Winstanley J, et al. Lymphoma occurring in patients with cutaneous melanoma. J Clin Pathol. 2010;63(9):777–81. CrossRef
- Ross MI, Thompson JF, Gershenwald JE. Sentinel lymph node biopsy for melanoma: critical assessment at its twentieth anniversary. Surg Oncol Clin N Am. 2011;20(1):57–78. CrossRef
- El Demellawy D, Ross C, Sur M, Alowami S. Synchronously diagnosed lymph nodal collision tumor of malignant melanoma and chronic lymphocytic leukemia/small lymphocytic lymphoma: case report. Diagn Pathol. 2007;2:34. CrossRef
- Adami J, Frisch M, Yuen J, Glimelius B, Melbye M. Evidence of an association between non-Hodgkin’s lymphoma and skin cancer. BMJ. 1995;310(6993):1491–5. CrossRef
- Landgren O, Pfeiffer RM, Stewart L, et al. Risk of second malignant neoplasms among lymphoma patients with a family history of cancer. Int J Cancer. 2007;120(5):1099–102. CrossRef
- Brennan P, Coates M, Armstrong B, Colin D, Boffetta P. Second primary neoplasms following non-Hodgkin’s lymphoma in New South Wales, Australia. Br J Cancer. 2000;82(7):1344–7. CrossRef
- Travis LB, Curtis RE, Glimelius B, et al. Second cancers among long-term survivors of non-Hodgkin’s lymphoma. J Natl Cancer Inst. 1993;85(23):1932–7. CrossRef
- Brennan P, Scelo G, Hemminki K, et al. Second primary cancers among 109 000 cases of non-Hodgkin’s lymphoma. Br J Cancer. 2005;93(1):159–66. CrossRef
- Hisada M, Biggar RJ, Greene MH, Fraumeni JF Jr, Travis LB. Solid tumors after chronic lymphocytic leukemia. Blood. 2001;98(6):1979–81. CrossRef
- Riou JP, Ariyan S, Brandow KR, Fielding LP. The association between melanoma, lymphoma, and other primary neoplasms. Arch Surg. 1995;130(10):1056–61. CrossRef
- Tsimberidou AM, Wen S, McLaughlin P, et al. Other malignancies in chronic lymphocytic leukemia/small lymphocytic lymphoma. J Clin Oncol. 2009;27(6):904–10. CrossRef
- Agnew KL, Ruchlemer R, Catovsky D, Matutes E, Bunker CB. Cutaneous findings in chronic lymphocytic leukaemia. Br J Dermatol. 2004;150(6):1129–35. CrossRef
- McKenna DB, Stockton D, Brewster DH, Doherty VR. Evidence for an association between cutaneous malignant melanoma and lymphoid malignancy: a population-based retrospective cohort study in Scotland. Br J Cancer. 2003;88(1):74–8. CrossRef
- Balamurugan A, Rees JR, Kosary C, Rim SH, Li J, Stewart SL. Subsequent primary cancers among men and women with in situ and invasive melanoma of the skin. J Am Acad Dermatol. 2011;65(5 Suppl 1):S69–77.
- Brewer JD, Shanafelt TD, Otley CC, et al. Chronic lymphocytic leukemia is associated with decreased survival of patients with malignant melanoma and Merkel cell carcinoma in a SEER population-based study. J Clin Oncol. 2012;30(8):843–9. CrossRef
- A Collision of Diseases: Chronic Lymphocytic Leukemia Discovered During Lymph Node Biopsy for Melanoma
Annals of Surgical Oncology
Volume 20, Issue 4 , pp 1360-1364
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Industry Sectors
- Author Affiliations
- 1. Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
- 2. Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, USA
- 3. Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
- 4. Department of Pathology & Cell Biology, University of South Florida Morsani College of Medicine, Tampa, FL, USA