Solid tumors after chronic lymphocytic leukemia patients: report of six cases and review of the literature

Introduction: Malignancies have been reported to occur with increased frequency in chronic lymphocytic Leukemia [CLL] patients. The aim of this study was to describe which second malignancies occur in patients with CLL, whether these malignancies are related to CLL, its treatment, or both. We also attempt to study factors predicting the development of other malignancies

Patients and methods: Between 1995 and 2009, six cases of CLL associated with solid tumor were diagnosed in Hematology Department of Military Hospital of Tunis. The diagnosis of CLL was made by immunophenotyping of peripheral blood circulating B cells, and the diagnosis of solid tumors was made by biopsy with anatomopathological exam and immunohistochemical study

Results: The mean age of patients was 71 years. Five patients were male. The CLL was classified Stage A in one case, Stage B in three cases and Stage C in two cases. Two patients had abnormal karyotype. Three patients have not received specific treatment for their CLL. Solid tumors were represented by skin cancer in three cases, lung cancer in two cases and breast cancer in one case. The median time between diagnosis of CLL and that of solid tumor was 53 months

Conclusion: Patients with CLL have an increased risk of developing a second cancer. Awareness of risk factors could permit early detection

[ value of tumor markers in pulmonary tuberculosis]

In thoracic oncology, no tumor marker has yet shown sufficient sensitivity nor specificity to be usefull for lung cancer diagnosis. However, in some cases, monitoring of tumor marker blood levels provides useful evaluation of response to specific treatment and assessment of infracfinical tumor progression. To determine the value of umor markers in pu1monar tuberculosis. A prospective study was conducte in our department during 2 years 2005 through 2007. We included 40 men who presented confirmed pulmonary tuberculosis. Before starting antituberculous chemotherapy, serum assays were practiced for the following tumor markers: NSE, CA 12.5, ACE and Cyfra 21.1. Mean age was 37, 12 years [17-81]. The levels of NSE were high in 91, 66%of cases with an average value of 29,22 micro g/l [2,24 X normal]. This highest sensitivity was superior to those of other tumor markers: 55, 55%for CA125, 28, 94%for ACE and 7,6%for Cyfra 21.1. Analysis of the levels of NSE according to age, tobacco consumption, delay of consultation, type of the pulmonary lesions and negativation delay in smear did not show any significas difference, whereas levels of CA 125 were higher in bilateral lesions [P=0, 05].The highest sensitivity of the NSE in pulmonary tuberculosis, with no neoplastic pathology could be interesting diagnosis of smear negative tuberculosis, with small amounts bacilli