Colliding / Concomitant Tumors of the Intestine: Report of 3 Cases

Sebastian MANNWEILER1, Hans Peter DINGES2, Christine BEHAM-SCHMID1, Hubert HAUSER3, Michael STARLINGER4, Sigrid REGAUER1

1Institute of Pathology, University of Graz, Graz, Austria
2Institute of Pathology, Landeskrankenhaus Klagenfurt, Klagenfurt, Austria
3Surgical Department, University of Graz, Graz, Austria
4Surgical Department, Landeskrankenhaus Klagenfurt, Klagenfurt, Austria


Collision/concomitant tumors of the intestine involving lymphomas are very rare. For these cases molecular genetic analyses are valuable diagnostic adjuncts. We report one collision tumor of the rectum (adenocarcinoma and peripheral T-cell lymphoma, unspecified), and two cases of concomitant tumors (carcinoma in the cecum and lymphoma in the ileum; carcinoma in the sigmoid and lymphoma in the ileum). The collision tumor (poorly differentiated adenocarcinoma and a peripheral T-cell lymphoma, unspezified) showed a variable proportion of the anaplastic tumor cells expressing lymphatic markers as well as cytokeratin. Only polymerase chain reaction (PCR) analysis revealing T-cell monoclonality of the anaplastic part of the colliding tumor allowed the correct diagnosis. In the second case, a moderately differentiated adenocarcinoma in the cecum with a concomitant B-cell Non-Hodgkin lymphoma in the ileum, PCR analysis was non contributary. In the third case (adenocarcinoma in the sigmoid colon and a follicular center lymphoma in the ileum) PCR analysis revealed gene rearrangement of the immunoglobulin heavy chain gene. We would like to emphasize that collision and concomitant tumors of the gut are rare and that molecular genetic analysis may be mandatory for correct diagnosis. It is our impression, that these tumors may be diagnosed more often in the intestinal tract if molecular genetic analysis and immunohistochemistry are used routinely, at least for all anaplastic tumors. Pathology & Oncology Research, Vol 9, Nr 3, 188-192, 2003

Key words: adenocarcinoma; non-Hodgkin lymphoma; colon; ileum

Received: Jun 10, 2003; accepted: Aug 25, 2003
Correspondence: Sebastian MANNWEILER, Institute of Pathology, University of Graz, Auenbruggerplatz 25 Graz A-8036, Austria; Tel: 43/316 3803688, Fax: 43/316 384329; E-mail:

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