A case of concurrent follicular lymphoma and lung cancer requiring differentiation from lymph node metastasis.

Lung cancer complicated by follicular lymphoma has rarely been reported in the literature. A 69-year-old male with an abnormal shadow on a chest radiograph was referred to our hospital. A mass in the right lung was seen on chest computed tomography (CT). Positron emission tomography-CT showed fluorodeoxyglucose accumulation in the esophagus and multiple intra-abdominal lymph nodes, in addition to the right lung lesion. The lung lesion was diagnosed as a pulmonary adenocarcinoma after biopsy. Upper and lower gastrointestinal endoscopies did not reveal the presence of a tumor. Open lymph node biopsy was performed to determine the course of treatment, leading to a diagnosis of follicular lymphoma. The patient finally underwent radical resection for lung cancer; the follicular lymphoma was judged to be low-grade and was followed up. When complications involving other organs are detected during systemic examination of a patient with lung cancer, it is necessary to distinguish between metastasis to other organs and complications of other malignant diseases, as this will greatly influence the treatment strategy.

Investigation of response of patients with non-small cell lung cancer to docetaxel (plus ramucirumab) therapy in second-line treatment.

BACKGROUND: Several options for second-line therapy are available for patients with advanced non-small cell lung cancer (NSCLC); however, the optimal therapy remains unclear. Docetaxel (DTX) monotherapy and DTX plus ramucirumab (RAM) are the recommended second-line treatment options. However, the efficacy of these treatments remains unsatisfactory. The aim of this study was to identify the clinical characteristics of patients with NSCLC who respond to DTX or DTX + RAM and factors that predict response. METHODS: Patients with NSCLC treated with DTX or DTX + RAM after second-line therapy were retrospectively analyzed. Patients were compared with those who responded or did not respond to the post-treatment efficacy assessment. RESULTS: Of 53 patients, 12 (22.6%) had lung cancer that responded to DTX or DTX + RAM therapy (response group). Multivariate analysis identified the absence of immune checkpoint inhibitors (ICIs) in the immediate prior therapy and a reduced dose of DTX after the second cycle as significant independent risk factors predicting nonresponse to DTX and DTX + RAM therapy in patients with NSCLC. The overall survival was significantly longer in the response group compared to the nonresponse group (p = 0.016). CONCLUSIONS: Our results suggest that DTX and DTX + RAM therapies immediately after treatment with ICI-containing regimens as well as continuation of DTX without dose reduction after the second cycle may increase the response rate and prolong survival in patients with NSCLC.