Collision tumour of the oesophagus: a challenge for histological diagnosis

An unusual case of mantle cell lymphoma metastasising to squamous cell carcinoma of the oesophagus, in a 62 year old Chinese man, is reported. A histological diagnosis based on examination of a small endoscopic biopsy specimen, in the absence of detailed clinical information, may be difficult, as the lymphoma component can be mistaken for reactive lymphoid infiltrate which is sometimes present adjacent to squamous cell carcinoma. Correlation with the clinical history, careful assessment of the subtle histological changes, and use of ancillary methods such as immunohistochemistry are most helpful in making the correct diagnosis. This case also illustrates further the possible occurrence of lymphomatous infiltrates surrounding other lesions in patients with a previous or concurrent history of lymphoma.