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Introduction: The association between axillary tuberculosis and breast cancer is rare, and only about thirty cases have been described in the literature. This entity must be mentioned in an endemic country faced with the notion of tuberculosis contagion. Case presentation: We report the case of a patient in whom the association between breast carcinoma and axillary tuberculosis discovery was fortuitous postoperatively. But retrospectivly her husband contracted the tuberculosis 30 years ago. She had mastectomy with axillary lymph node dissection because the tumour was multifocal. The carcinoma was classified as pT2N0M0 (stage IIA classification TNM) and she was only put on hormone therapy. After 5 years of follow-up, no recurrence was noted despite the therapeutic insufficiency. Conclusion: Mammary lymph node tuberculosis is rare; it must be mentioned in the context of tuberculosis contagion or in front of the the presence of calcifications in the axillary area on the x-ray. At the slightest suspicion of this diagnosis, the operating parts should not be fixed but sent in the fresh state for a ZIEHL-NELSEN staining for the detection of Koch's bacillus or for a culture. The anti-tuberculosis treatment should be immediately started after the surgery. If the cancer target is indicated, it should not be started until after 1 month of tuberculosis treatment, given the risk of tuberculosis outbreak.

Introduction and importance The association of colonic adenocarcinoma with lymphoma is a rare entity. The purpose of our presentation is to draw the attention of the endoscopist, and the surgeon, to the need to remove any suspicious lesions in the exploration for colorectal cancer. The pathologist should be warned about this association in the face of any unusual change in the lymphatic environment around an adenocarcinoma. In the slightest doubt, an immunohistochemistry (IHC) should be performed in order not to ignore this association. Case presentation A 77-year-old patient, who had adenocarcinoma of the right colic flexure, in whom a chance discovery of lymphoma was made intraoperatively. This combination was treated with chemotherapy targeting adenocarcinoma classified as pT4N1M0, ahead of the low-grade lymphoma malignancy. After two years, the patient presented with a recurrence as left lateral cervical lymphadenopathy and died in a picture of generalized paralysis. Clinical discussion Digestive lymphoma associated with adneocarcinoma is defined according to strict criteria according to DAWSON. It always precedes adenocarcinoma because it disrupts the subject's immunocompetence. His diagnosis is suspected when the lymphatic environment around the adenocarcinoma is disturbed. The confirmation is assured with the IHC. Treatment should target the most aggressive cancer. Conclusion The synchronous colonic occurrence of a MALT-type lymphoma and an adenocarcinoma is rare but possible. The pathologist must be alert to its existence. Treatment depends on the tumor stage of the adenocarcinoma but also on the lymphoma and its grade and any therapeutic decision should only be made in a multidisciplinary meeting., Highlights • Lymphoma by impairing the subject's immunocompetence could accelerate the malignant degeneration of an existing precancerous colonic lesion to an adenocarcinoma. • Any erasure of the architecture of lymph nodes in the dissection specimen of colonic adenocarcinoma giving rise to suspicion of lymphomatous infiltration, should confirmed by immunohistochemical testing. • If an association between colonic adenocarcinoma and lymphoma is encountred, the most aggressive and/or evoluted neoplasm must be targeted in priority. • The first treatment of a digestive lymphomatous pathology associated with an adenocarcinoma can provoke general dissemination.

Synchronous presentation of a colonic adenocarcinoma and lymphoma is extremely rare. We describe here, the sixth observation of a marginal zone B-cell lymphoma, which was incidentally diagnosed in a 77-year-old patient, who was operated for adenocarcinoma of hepatic flexure. This case shows the importance to be aware of this rare association and highlights the dilemma of its management.