Medicine · 2018
Rare intestinal fistula caused by primary lymphoma of the gastrointestinal tract: Two case reports and literature review.
Клинический случайСтатьяОбзорНазвание и аннотация: Перевод пока не подготовлен
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Zhuang Nan, Zhu Qingli, Li Wenbo, Wang Miaoqian, Yang Qian, Liu Wei, Li Ji, Yang Hong, Zhou Weixun
Аннотация
RATIONALE: Primary lymphoma that arises from the intestine is an uncommon malignant tumour, while intestinal fistula caused by primary lymphoma is even rarer. Non-specific clinical performance makes early diagnosis difficult, although imaging modalities might play an essential role in the detection of intestinal fistula.
PATIENT CONCERNS: Patient 1: A 60-year-old male hospitalized with diarrhoea and abdominal pain for seven months underwent computed tomography enterography (CTE) that demonstrated ileum internal fistula and ileac-sigmoid colon fistula. Ultrasound (US) showed small intestinal wall thickened and development of a fistula of the sigmoid colon due to malignance. Patient 2: A 43-year-old male presented with abdominal pain and diarrhoea lasting one year. US revealed a fistula between the sigmoid colon and the ileum, and CTE showed that the wall of the partial sigmoid colon was abnormally thickened and enhanced with an ileal-sigmoid fistula that strongly suggested the diagnosis of lymphoma.
DIAGNOSES: Both the two patients were diagnosed as intestinal fistula caused by primary non-Hodgkin's intestinal lymphoma.
INTERVENTIONS: The patient 1 underwent surgery followed by chemotherapy. The patient 2 accepted chemotherapy.
OUTCOMES: Two patients' general conditions remained stable and the imaging revealed no recurrence after follow-up of about 12 months.
LESSIONS: Cross-sectional imaging, such as US and CT, plays an essential role in intestinal lymphoma fistula diagnosis.
PATIENT CONCERNS: Patient 1: A 60-year-old male hospitalized with diarrhoea and abdominal pain for seven months underwent computed tomography enterography (CTE) that demonstrated ileum internal fistula and ileac-sigmoid colon fistula. Ultrasound (US) showed small intestinal wall thickened and development of a fistula of the sigmoid colon due to malignance. Patient 2: A 43-year-old male presented with abdominal pain and diarrhoea lasting one year. US revealed a fistula between the sigmoid colon and the ileum, and CTE showed that the wall of the partial sigmoid colon was abnormally thickened and enhanced with an ileal-sigmoid fistula that strongly suggested the diagnosis of lymphoma.
DIAGNOSES: Both the two patients were diagnosed as intestinal fistula caused by primary non-Hodgkin's intestinal lymphoma.
INTERVENTIONS: The patient 1 underwent surgery followed by chemotherapy. The patient 2 accepted chemotherapy.
OUTCOMES: Two patients' general conditions remained stable and the imaging revealed no recurrence after follow-up of about 12 months.
LESSIONS: Cross-sectional imaging, such as US and CT, plays an essential role in intestinal lymphoma fistula diagnosis.