One patient, two lymphomas, three primaries.

Concomitant adenocarcinoma and non-Hodgkin's lymphoma, both located in the intestinal tract, are unusual. Collision tumors of the colon on the other hand are extremely rare neoplasms. A case of true collision tumor of a marginal zone lymphoma and a moderately differentiated adenocarcinoma of the ascending colon (hepatic flexure) is reported. Simultaneously, a third primary is identified as follicular lymphoma involving the terminal ileum. Correlation with clinical history, radiology investigations, endoscopic findings and histological examination of the resected specimen as well as the use of ancillary techniques such as immunohistochemistry are the most useful in making the correct diagnosis of a synchronous three primaries involving the small bowel and colon. Therefore, we present these three primary synchronous neoplasms involving two different parts of the gastrointestinal tract, with two of these three primaries colliding at one organ.

Upper gastrointestinal tract bleeding caused by a gastrointestinal stromal tumor of the stomach: a case report.

We report a case of upper gastrointestinal bleeding caused by a gastrointestinal stromal tumor in a 50-year old man. The patient was having melena for two months, and on admission he was hemodynamically stable. Upper G.I endoscopy showed diffuse gastritis and an extrinsic compressing mass in the upper part of the stomach. CT scan of the abdomen showed exophytic mass in the fundus of the stomach, with central necrosis. The patient was submitted to operative management. There were no features of dissemination but there was invasion of the hilum of the spleen. Wide local resection and splenectomy performed. Post operative course was complicated by a bleeding from the anastomotic site that required re-exploration and suturing of the bleeding vessel. Histologic examination revealed that it was composed of spindle-shaped cells with elongated nuclei. Post operatively the patient received adjuvant treatment with Imatinib [Gleevec]. The patient has an uneventful follow-up period so far.