Poster: ABCL-260 Coexistence of Non-Hodgkin Lymphoma and Rectal and Stomach Adenocarcinomas: A Case Report

The exceptional case described by us involves several malignant neoplasms in one person at the same time and the patient's death from COVID-19 complications. Case Presentation: A 74-year-old woman had suffered from marginal zone B-cell lymphoma since 2007. She was under observation until 2013 when there was a progression of the disease. She received 6 non-complete courses of chemotherapy by the R-CVP program. The 6th course was completed in February 2014 because of neuropathy. As a result, clinical hematological remission was registered. Until 2018, the situation was stable and dynamic control continued. In 2018-2019, a tendency toward lower hemoglobin was observed, CT revealed a conglomerate up to 11 cm in the abdomen, a biopsy of the axillary lymph nodes was performed, and Grade I follicular lymphoma was found. The size of the conglomerate did not change during the year and iron deficiency anemia was expressed in the blood test, though other test indicators were within the norm. Significant weight loss of 10 kg was observed in 1.5 years. In February 2019, a colonoscopy was performed, revealing a tumor, and in March 2019, a hemicolectomy was performed. Immunohistochemical examination of the removed tumor confirmed invasive mucinous adenocarcinoma Low-Grade p73pN1b (2/12) pMxL1V0Pn0Rx. The patient continued with permanent diarrhea and anemia. After two years, in May 2021, the patient was admitted for chronic muscular pain. During hospitalization, an episode of melena occurred, following which she underwent both colonoscopy and gastroscopy; the latter disclosed an approximately 1.2-cm lesion in the greater curvature of the stomach. The patient underwent trepan biopsy, which revealed intestinal-type gastric adenocarcinoma. The patient received 3 courses of rituximab monotherapy and was discharged before surgery. However, COVID-19 changed the plans of the doctors and the patient died from its complications in the intensive care unit. Conclusions: The synchronous occurrence of non-Hodgkin lymphoma and rectal and stomach adenocarcinoma is rare but possible. Doctors must be alert to its existence. Treatment depends on the tumor stage of the adenocarcinomas but also the lymphoma and its grade, and any therapeutic decision should only be made in a multidisciplinary meeting.