Ileocolic intussusception in adult due to malignant lymphoma in the cecum with intramural metatasis

Takiguchi, Nobuhiro; Sarashina, Hiromi; Saitoh, Norio; Nunomura, Masao; Kouda, Keiji; Ozaki, Ko; Nakajima, Nobuyuki; Fujihira, Takeo; Mikata, Atsuo

doi:10.1007/bf02355066

Cited by 7 publications

(3 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A search of PubMed from 1990 to 2017 found only one case of DIS of colonic malignant lymphoma with intussusceptions (12). Thus, the present case is the first report of DIS of colonic epithelial neoplasm.…”

Section: Discussionmentioning

confidence: 63%

See 1 more Smart Citation

Rare Case of Cecal Signet Ring Cell Carcinoma with Distal Intramural Spread

Ono

Murakami

Watanabe

et al. 2017

View full text Add to dashboard Cite

Abstract. In this paper, we report a rare case of cecalSignet ring cell carcinoma (SRCC) leucovorin, and irinotecan plus cetuximab). At a follow-up examination nine months after surgery, she was found to be doing well.The existence of microscopic tumor implants in the intestinal wall, distal to the inferior edge of a macroscopic tumor (either continuous or discontinuous with the tumor), is called distal intramural spread (DIS) (1). The rate of DIS in rectal cancer is reported as 14.7% (2) to 83.6% (3). On the contrary, DIS has not been reported in colonic cancer and is considered rare. DIS is classified as continuous or discontinuous lesions. Discontinuous lesions spread from the distal side of the main tumor through the normal epithelium. These lesions are called skip lesions (4). Skip lesions are thought to invade the submucosal or muscular layers through the lymphatic vessels (5, 6).More than 90% of colorectal carcinomas are adenocarcinomas originating from epithelial cells of the colorectal mucosa (7). According to a previous report (8), 2.63% of patients with colonic cancer had Signet ring cell carcinomas (SRCC). In this study we report a rare case of cecal SRCC with DIS diagnosed pathologically. Case ReportA 71-year-old woman with hypertension and dyslipidemia was referred to another hospital with vomiting, abdominal pain, and abdominal distension. She was suspected of having ileus and was transferred to our hospital. Contrast enema showed a cecal mass. There was no flow of contrast medium into the ileum. Colonoscopy showed complete stenosis of the ascending colon. Pathological examination showed SRCC. Upper gastrointestinal endoscopy did not indicate any neoplastic lesion. Computed tomography (CT) of the abdomen showed a thickening of the cecal wall with fluid accumulation in the distal ileum. Swelling of lymph nodes around the cecum, ascites, and peritoneal metastasis were observed (Figure 1). The level of carcinoembryonic antigen (CEA) was 6.8 ng/ml. Other laboratory results were normal. She was clinically diagnosed with cecal cancer, which caused ileus and carcinomatous peritonitis. Surgery was performed by iliocecal resection with lymphadenectomy. Pathological examination of the resected specimen showed SRCC invading all layers of the cecal wall. There was massive invasion of the lymphatic vessels and venous vessels ( Figure 2) and metastasis to the lymph nodes.A submucosal nodule (diameter, 10 mm) was located 55 mm from the distal side of the main tumor through the normal epithelium (Figure 3). This lesion was also diagnosed as SRCC. It was located in the muscularis propria to subserosa. Because no carcinoma cells were exposed to the epithelium or serosa, we diagnosed the lesion as DIS of cecal SRCC (Figure 4). The final pathological stage was 705

show abstract

Section: Discussionmentioning

confidence: 63%

“…DIS is a type of cancerous metastasis that is regarded not only as a marker to identify the surgical margin during operation (1) but also as an index for the prognosis of rectal cancer (12). It has also been reported to be related to the depth of cancer invasion (5).…”

Section: Discussionmentioning

confidence: 99%

Rare Case of Cecal Signet Ring Cell Carcinoma with Distal Intramural Spread

Ono

Murakami

Watanabe

et al. 2017

View full text Add to dashboard Cite

show abstract

“…In our case, a 53-year-old male with diffuse large B-cell lymphoma involving the terminal ileum and had caused an ileocolic intussusception. Our literature search revealed that few cases of B-cell lymphoma, presenting as intussusceptions of terminal ileum, in HIV-seronegative adults, have ever been reported [5–8]. …”

Section: Discussionmentioning

confidence: 99%

Telescoping Intestine in an Adult

Shaheen

Eisa

Alraiyes

et al. 2013

Case Reports in Medicine

View full text Add to dashboard Cite

Protrusion of a bowel segment into another (intussusception) produces severe abdominal pain and culminates in intestinal obstruction. In adults, intestinal obstruction due to intussusception is relatively rare phenomenon, as it accounts for minority of intestinal obstructions in this population demographic. Organic lesion is usually identifiable as the cause of adult intussusceptions, neoplasms account for the majority. Therefore, surgical resection without reduction is almost always necessary and is advocated as the best treatment of adult intussusception. Here, we describe a rare case of a 44-year-old male with a diffuse large B-cell lymphoma involving the terminal ileum, which had caused ileocolic intussusception and subsequently developed intestinal obstruction requiring surgical intervention. This case emphasizes the importance of recognizing intussusception as the initial presentation for bowel malignancy.

show abstract

Non-Hodgkin's Lymphoma of the Ascending Colon in a Patient with Becker Muscular Dystrophy: Report of a Case

Uotani¹,

Hirokawa²,

Saito³

et al. 2001

Surgery Today

View full text Add to dashboard Cite

We herein present the findings of a 10-year-old boy with non-Hodgkin's lymphoma of the ascending colon which caused intussusception and intestinal bleeding. He had a history of Becker muscular dystrophy. However, he had neither hypertrophic calves nor cardiomyopathy, and his serum creatine kinase (CK) level always exceeded 2000 IU/l. Preoperatively, a laboratory examination revealed high serum levels of CK (2038IU/l), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH), and the blood hemoglobin level was 7.0g/dl. A barium enema examination revealed an intussusception in his ascending colon, which was found to be a highly vascular tumor on Doppler ultrasound scans. A right hemicolectomy was performed. Macroscopically, the 5 x 6 x 8-cm solid tumor of the ascending colon resembled a submucosal tumor and had two ulcerous lesions at the tip. The tumor was histologically diagnosed to be a diffuse large B-cell lymphoma of the ascending colon. General examinations revealed no involvement of lymphoma postoperatively. At 13 months after surgery, the CK (37861U/l), AST (110lU/l), ALT (1381U/ l), and LDH (420lU/l) levels are still high, and the patient is doing well without any signs of recurrence.

show abstract

Ileocolic intussusception in adult due to malignant lymphoma in the cecum with intramural metatasis

Cited by 7 publications

References 17 publications

Rare Case of Cecal Signet Ring Cell Carcinoma with Distal Intramural Spread

Rare Case of Cecal Signet Ring Cell Carcinoma with Distal Intramural Spread

Telescoping Intestine in an Adult

Non-Hodgkin's Lymphoma of the Ascending Colon in a Patient with Becker Muscular Dystrophy: Report of a Case

Contact Info

Product

Resources

About