Incidental finding of multiple diffuse large B-cell lymphomas masquerading as jejunojejunal intussusception with unexplained pleural effusion: a case report

Abstract

Introduction: Primary non-Hodgkin’s lymphoma of the gastrointestinal (GI) tract is rare. It is aggressive and necessitates early diagnosis and management. Simultaneous primary GI lymphomas are unusual with rarely reported cases. Case presentation: This novel case report describes an 84-year-old man with multiple primary diffuse large B-cell lymphomas (DLBCLs) of the jejunum with disseminating pleural and multiple regional lymph nodes involvement presenting as intestinal obstruction and segments of jejunojejunal intussusception. The patient underwent surgical intervention and adjuvant chemotherapy. Unfortunately, the patient suffered from multiple organ failure and died 4 months after surgery. Clinical discussion: Obstruction and perforation are rare and life-threatening complications of GI lymphoma. Multiple DLBCLs of the jejunum are rare. Moreover, primary GI-DLBCL that initially presents with pleural effusion or with intestinal perforation is uncommon. This report aims to remind clinicians that lymphoma should be considered when assessing the cause of unexplained pleural effusion, especially when the available examination data cannot be confirmed by clinical manifestations. Conclusion: Through this case report, the authors learn that clinical manifestations, morphological characteristics, immunophenotypes, and molecular biological characteristics are vastly different and important. This poses the biggest challenge before surgery and should not be ignored.

Diffuse large B‐cell lymphoma‐induced intussusception: A case report and literature review

“…Here, we report a case of large B‐cell lymphoma, a subtype of GI lymphoma. The GI tract is recognized as the predominant site of extranodal lymphoma manifestation 16 . Most studies indicate that the stomach is the site most frequently affected by GI lymphoma, accounting for 50%–60% of cases.…”

“…The GI tract is recognized as the predominant site of extranodal lymphoma manifestation. 16 Most studies indicate that the stomach is the site most frequently affected by GI lymphoma, accounting for 50%–60% of cases. The small intestine follows in terms of incidence, while the colon, rectum, and esophagus are less commonly involved, with each one involving less than 1% of cases.…”