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Synchronous occurrence of multiple malignancies i.e.: epitheliod and lymphoproliferative are rare but well reported. Here we have presenting a case of 82 year old male, known smoker, admitted at Shifa International Hospital Islamabad, with complaints of shortness of breath, productive cough, weight loss, generalized weakness and cervical lymphadenopathy. The laboratory investigations; complete blood counts and peripheral blood showed patient is having absolute lymphocytosis with flow cytometric analysis performed on peripheral blood revealing B-cell Non Hodgkin lymphoma. However p deletion was not detected on using fluorescence in-situ hybridization. Although bone marrow biopsy examination was surprisingly seen with multiple cohesive metastatic clumps and dispersed atypical cells with positivity of CKAE1/AE3, CD56, TTF1 giving diagnosis of metastatic lung carcinoma. Hence occurrence of both epitheliod and lymphoproliferative malignancy was made and reported in Pakistan most likely for the first time.

Synchronous Occurrence of B-Cell Non Hodgkin Lymphoma and Metastatic Small Cell Carcinoma of Lung