Monday, July 6th, 2020


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Metastasis of Prostatic Adenocarcinoma in a Lymph Node Affected by Hodgkin Lymphoma: A Case Report
Authors:  Nataniele Piol, M.D., Rita Bianchi, M.D., Francesca Pitto, M.D., Marco Mora, M.D., Carlo Terrone, M.D., Valerio G. Vellone, M.D., Ph.D., Antonio Lopez-Beltran, M.D., Ph.D., Carlo Toncini, M.D., and Bruno Spina, M.D.
  BACKGROUND: Multiple primary tumors in the same patient are reported to occur in the range of 2–17%. Histopathological recognition of an unsuspected tumor is important as it could influence therapeutic decisions and affect patients’ prognosis, but synchronous concomitant malignancies can be a diagnostic challenge for the pathologist. CASE: We report a case of prostatic acinar adenocarcinoma metastatic to a pelvic lymph node also affected by Hodgkin disease in a 73-year-old man. After prostatic biopsies positive for prostatic adenocarcinoma, the patient underwent a radical prostatectomy with bilateral pelvic lymphadenectomy. Pathological examination confirmed the initial diagnosis, revealing a bilateral high-grade prostatic adenocarcinoma involving about 70% of the prostate with extensive extracapsular invasion. A metastasis of prostatic adenocarcinoma was found in 1 of the left pelvic lymph nodes; all pelvic lymph nodes showed an architectural effacement due to a distinct neoplastic proliferation characterized by large cells consistent with Reed-Sternberg and Hodgkin cells, confirmed by immunohistochemistry reactions.
This case is, to the best of our knowl-edge, the first case of a urological neoplasm, namely a prostatic acinar adenocarcinoma, metastasizing to a lymph node simultaneously involved by Hodgkin disease.
Keywords:  adenocarcinoma, collision metastasis, Hodgkin lymphoma, lymph node, metastasis, pelvic lymph node, prostate, prostate cancer, prostatic neoplasms, prostatic adenocarcinoma
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