Klinicka onkologie : casopis Ceske a Slovenske onkologicke spolecnosti · 2022
Diffuse large B-cell lymphoma associated ileocecal intussusception in adulthood.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Rajabto W, Priantono D, Harahap A S, Handjari D R
Аннотация
BACKGROUND: Intussusception in adults is considered a rare condition, accounting for 5% of all cases of intussusceptions and approx. 1-5% of bowel obstruction. Almost half intussusceptions of the bowel are associated with malignant disease; thus, we should also treat the underlying malignancy.
CASE DESCRIPTION: A 52-year-old male presented with colicky right lower abdominal pain for a 6-month period. He had a weight loss of 20kg within 6 months. Physical examination revealed a tender right lower abdominal mass. Colonoscopy showed a mass that filled the ileocecal. The digestive surgeon performed laparoscopic right hemicolectomy with end-to-end anastomosis. Histopathology examination showed diffuse proliferation of large tumor cells with centroblastic-like features prominently in submucosal area, with normal epithelial mucosa. The immunohistochemistry result concluded the final dia-gnosis of diffuse large B-cell lymphoma. RCHOP chemotherapy regimens were administered every 3 weeks for 6 cycles. The response was complete remission.
DISCUSSION: Intussusception was preoperatively dia-gnosed by multi-slice spiral CT scans with the characteristic target or sausage sign, edematous bowel wall and mesentery in the lumen. After surgery, approximately 90% of adult intussusception cases have a demonstrable etiology. Malignant lymphoma, especially diffuse large B-cell lymphoma, of the ileocecal is one cause of the adult intussusception.
CONCLUSION: Adult bowel intussusception is a rare clinical entity. Abdominal CT is considered as the most sensitive imaging modality in the dia-gnosis of intussusception. Diffuse large B-cell lymphoma is the most common cause of ileocecal intussusception.
CASE DESCRIPTION: A 52-year-old male presented with colicky right lower abdominal pain for a 6-month period. He had a weight loss of 20kg within 6 months. Physical examination revealed a tender right lower abdominal mass. Colonoscopy showed a mass that filled the ileocecal. The digestive surgeon performed laparoscopic right hemicolectomy with end-to-end anastomosis. Histopathology examination showed diffuse proliferation of large tumor cells with centroblastic-like features prominently in submucosal area, with normal epithelial mucosa. The immunohistochemistry result concluded the final dia-gnosis of diffuse large B-cell lymphoma. RCHOP chemotherapy regimens were administered every 3 weeks for 6 cycles. The response was complete remission.
DISCUSSION: Intussusception was preoperatively dia-gnosed by multi-slice spiral CT scans with the characteristic target or sausage sign, edematous bowel wall and mesentery in the lumen. After surgery, approximately 90% of adult intussusception cases have a demonstrable etiology. Malignant lymphoma, especially diffuse large B-cell lymphoma, of the ileocecal is one cause of the adult intussusception.
CONCLUSION: Adult bowel intussusception is a rare clinical entity. Abdominal CT is considered as the most sensitive imaging modality in the dia-gnosis of intussusception. Diffuse large B-cell lymphoma is the most common cause of ileocecal intussusception.