CLL Coverage from Every Angle

Concurrent Adenoid Cystic Carcinoma and CLL: Case Report

By: Cordi Craig, MS
Posted: Tuesday, April 13, 2021

Although the link between chronic lymphocytic leukemia (CLL) and solid tumors is well documented, Georges Sinclair, MD, of the Royal Berkshire NHS Foundation Trust, Reading, United Kingdom, and colleagues presented a novel case of CLL and concurrent adenoid cystic carcinoma. According to the authors, immunodeficiency and tobacco smoking appear to be causal factors. The case study, published in BMJ Case Reports, indicates that clinicians should be vigilant about the development of primary lung tumors in patients with CLL.

A 59-year-old man presented with a 6-month history of a nonproductive cough and breathlessness. The patient was an active smoker with a medical history of atrial fibrillation and cardiomyopathy. The chest screening revealed a right upper lobe mass, determined to be an adenoid cystic carcinoma of the lung. Local lymph node dissection revealed a CLL diagnosis. In addition to the case report, the authors retrospectively explored the potential connection between CLL and solid tumors.

A restaging CT scan performed 6 months after adjuvant radiotherapy revealed no sign of local or metastatic recurrence in the featured patient. When the case was published, the patient was being treated with dexamethasone for grade 2 radiation-induced pneumonitis.

Retrospective analyses suggested that smoking is the most important modifiable factor to play a role in the relationship between CLL and solid-organ malignancies; thus, clinicians should strongly encourage complete smoking cessation for all patients. Immunodeficiency in CLL may also be a causal factor in the relationship. Of note, evidence suggested that HER2 testing may be particularly relevant, as it appeared that lung carcinomas developed in patients with CLL who had an excess of HER2 overexpression.

Disclosure: The study authors reported no conflicts of interest.

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