Diffuse Large B-Cell Lymphoma With Tracheoesophageal Fistula Healed Using Chemotherapy: A Case Report and Review of the Literature

Malignant lymphomas are rarely associated with tracheoesophageal or bronchoesophageal fistulas (TEFs/BEFs). Lymphomas accompanied by TEFs/BEFs have a more favorable prognosis than solid tumors. Here, we present a unique case of a 74-year-old patient with diffuse large B-cell lymphoma (DLBCL). Contrast-enhanced computed tomography (CT) revealed TEF, aspiration pneumonia, and multiple lymphadenopathy. Histopathology helped confirm DLBCL, leading to a Lugano IIE staging. Complete DLBCL remission could be achieved by adjusting chemotherapy dosages for complications, which also resulted in spontaneous TEF resolution without requiring interventions such as stent insertion or surgical correction. No instances of lymphoma recurrence or tracheoesophageal fistula were observed 46 months post-chemotherapy. Among 33 documented cases, this is the first instance of DLBCL-associated TEF resolution through chemotherapy. Notably, in patients initially presenting with a fistula prior to treatment initiation, a favorable response to chemotherapy and/or radiotherapy coupled with controlled aspiration could potentially lead to the resolution of the fistula. Collectively, our case highlights the potential for conservative fistula management and the possibility of spontaneous resolution with chemotherapy. Our report provides valuable insights into lymphoma-associated fistulas and their management.