{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:30:21Z","timestamp":1787841021009,"version":"build-2784847793"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Simultaneous occurrence of colonic adenocarcinoma and appendiceal lymphoma in a patient with chronic lymphocytic leukaemia (CLL) is exceedingly rare. This unique coexistence presents diagnostic and therapeutic challenges, particularly in elderly patients with comorbidities. We report an unusual case of caecal adenocarcinoma and diffuse large B-cell lymphoma (DLBCL) of the appendix in a patient with known CLL. An 87-year-old male with a known diagnosis of CLL presented with a suspected caecal mass on imaging. Colonoscopy revealed a polypoidal caecal lesion, and biopsy confirmed adenocarcinoma. He underwent laparoscopic right hemicolectomy. Histopathology revealed moderately differentiated adenocarcinoma (pT3N0M0) and synchronous DLBCL in the appendix and mesenteric nodes, consistent with Richter\u2019s transformation. The patient was restarted on ibrutinib postoperatively. At 1.5 years, he developed an anastomotic recurrence managed with laparoscopic re-resection. He remains disease-free 3 years post-index surgery under multidisciplinary follow-up. This case highlights the importance of considering dual pathology in CLL patients presenting with gastrointestinal symptoms. Curative surgical resection, combined with targeted haematological therapy and regular surveillance, can result in favourable outcomes even in elderly patients with complex malignancies.<\/jats:p>","DOI":"10.4103\/jmas.jmas_285_25","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T11:00:08Z","timestamp":1763982008000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Incidental simultaneous caecal adenocarcinoma with appendix lymphoma in chronic lymphocytic leukaemia"],"prefix":"10.4103","author":[{"given":"Lakshay","family":"Singla","sequence":"first","affiliation":[{"name":"Department of General Surgery, Whiston Hospital, Mersey and West Lancashire Teaching Hospitals NHS Trust, Prescot, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramya","family":"Kalaiselvan","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Whiston Hospital, Mersey and West Lancashire Teaching Hospitals NHS Trust, Prescot, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,11,24]]},"reference":[{"key":"R1-20251124","first-page":"209","article-title":"Global cancer statistics, 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"R2-20251124","first-page":"742146","article-title":"Colonic involvement in a patient with chronic lymphocytic leukaemia","author":"Arkkila","year":"2008","journal-title":"Gastroenterol Res Pract 2008"},{"key":"R3-20251124","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1155\/2012\/480160","article-title":"Increasing incidence rates, distribution and histological characteristics of primary gastrointestinal non-Hodgkin lymphoma in a North American population","volume":"26","author":"Howell","year":"2012","journal-title":"Can J Gastroenterol"},{"key":"R4-20251124","first-page":"629","article-title":"Primary appendiceal lymphoma presenting as perforated acute appendicitis","volume":"67","author":"Fu","year":"2004","journal-title":"J Chin Med Assoc"},{"key":"R6-20251124","first-page":"337","article-title":"Subsequent cancer in patients with chronic lymphocytic leukemia \u2013 A possible immunologic mechanism","volume":"61","author":"Greene","year":"1978","journal-title":"J Natl Cancer Inst"},{"issue":"Suppl 2","key":"R7-20251124","first-page":"S50","article-title":"Gastrointestinal involvement in patients with chronic lymphocytic leukemia","volume":"11","author":"Kuse","year":"1997","journal-title":"Leukemia"},{"key":"R8-20251124","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1007\/s12029-010-9226-0","article-title":"Richter's syndrome in colon: Case report","volume":"43","author":"Chacaltana","year":"2010","journal-title":"J Gastrointestinal Cancer"},{"key":"R9-20251124","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1007\/BF02555022","article-title":"Richter's syndrome mimicking chronic colitis. A patient with diffuse histiocytic lymphoma complicating chronic lymphocytic leukemia","volume":"29","author":"Wilson","year":"1986","journal-title":"Dis Colon Rectum"},{"key":"R10-20251124","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1007\/s10350-004-6161-9","article-title":"Non-Hodgkin's lymphoma in a patient with probable hereditary nonpolyposis colon cancer: Report of a case and review of the literature","volume":"45","author":"Hirano","year":"2002","journal-title":"Dis Colon Rectum"},{"key":"R11-20251124","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1182\/blood.V85.6.1580.bloodjournal8561580","article-title":"p53 gene deletion predicts for poor survival and non-response to therapy with purine analogs in chronic B-cell leukemias","volume":"85","author":"D\u00f6hner","year":"1995","journal-title":"Blood"},{"key":"R12-20251124","first-page":"302","article-title":"Collision in the colon: Concurrent adenocarcinoma and diffuse large B-cell lymphoma in the same tumour","volume":"66","author":"Chang","year":"2011","journal-title":"Acta Clin Belg"}],"container-title":["Journal of Minimal Access Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jmas.jmas_285_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:39:35Z","timestamp":1787837975000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jmas.jmas_285_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,24]]},"references-count":11,"URL":"https:\/\/doi.org\/10.4103\/jmas.jmas_285_25","relation":{},"ISSN":["0972-9941","1998-3921"],"issn-type":[{"value":"0972-9941","type":"print"},{"value":"1998-3921","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,24]]},"assertion":[{"value":"2025-07-08","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-25","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}