Adult ileocolic intussusception with lymphoma as the lead point: a case report.

Adult ileocolic intussusception is almost always associated with a pathological lead point. We present a 29-year-old male with autism spectrum disorder (ASD) who attended with a one-week history of colicky right iliac fossa pain and loose stools. Communication difficulties related to ASD delayed a clear clinical history. Abdominal ultrasonography demonstrated a 7.0 × 6.0 cm target sign in the subhepatic region. Contrast-enhanced computed tomography confirmed ileocolic intussusception extending to the hepatic flexure, with a heterogeneously enhancing 6.6 × 4 × 3.4 cm lead-point mass. Diagnostic laparoscopy was converted to open right hemicolectomy with ileocolic anastomosis. Histopathology revealed B-cell non-Hodgkin lymphoma, confirmed by immunohistochemistry (CD20+, BCL2+, BCL6+, MUM1+, and c-MYC+). The patient was referred for oncological management and was well at one-month review. This case highlights that adult intussusception caused by lymphoma can present insidiously, particularly in patients with impaired communication, and that early cross-sectional imaging and prompt surgical resection are essential.