Intussusception as clinical presentation of primary non-Hodgkin lymphoma of the colon in a HIV-patient

Abstract

Intestinal intussusception rarely occurs in the adult population and accounts only for 1% to 5% of all the causes of intestinal obstruction. This complication is more frequent in the small bowel and can be due to different aetiologies, including inflammatory, infectious or neoplastic diseases. Malignancies account for 50% to 60% of all cases of colon invagination. The gastrointestinal (GI) tract is the most common site for extra-nodal non-Hodgkin lymphomas (NHL), representing 5% to 20% of all the cases. However, primary NHL of the GI tract is a very infrequent clinic-pathological entity and accounts only for 1% to 4% of all the neoplasms of the GI tract. Primary NHL of the colon is a rare disease and it comprises only 0.2% to 1.2% of all colonic malignancies. Here we describe a case of an AIDS adult patient who developed an intussusception secondary to a primary large B cell lymphoma of the transverse colon. English and Spanish literature was reviewed.

Adult intussusception in the era of HIV/AIDS: A case report

“…The clinical manifestations of primary intestinal lymphoma include nausea and vomiting, insidious abdominal pains, ‘B’ symptoms (i.e., weight loss, fever and night sweats), abdominal mass and haematochesia. 10 However, our patient presented late with features of small bowel obstruction and peritonism. Peritoneal signs and elevated septic markers were probably attributed to ruptured granulomas with intra-abdominal pus.…”

“…While abdominal ultrasound is considered comparable to CT scan for sensitivity and specificity, it is operator dependent. 10 It carries the advantage of being relatively cheap, non-invasive, and readily available. 10 The classic ultrasonographic features of intussusception include target sign or doughnut sign on axial view as well as pseudo-kidney sign or hayfork sign on longitudinal plane.…”

“… 10 It carries the advantage of being relatively cheap, non-invasive, and readily available. 10 The classic ultrasonographic features of intussusception include target sign or doughnut sign on axial view as well as pseudo-kidney sign or hayfork sign on longitudinal plane. 10 Computed tomography scan has a superior value in defining the location and in characterising the tumour and its association with surrounding structures.…”

Complicaciones quirúrgicas del linfoma con compromiso gastrointestinal

“…En adultos la obstrucción intestinal por intususcepción representa del 1 al 5 % de todas las causas mecánicas de obstrucción. En niños es una causa más frecuente de obstrucción intestinal, ya que el 90 % de los casos son idiopáticos, a diferencia de la población adulta, donde la mayoría tienen una patología que predispone a la intususcepción al generar un punto de fijación en un segmento intestinal 7,29 . En el colon la intususcepción es secundaria a un tumor maligno en el 65 al 70 % de los casos, mientras que en el intestino delgado del 30 al 35 % se relacionan con malignidad 30,31 .…”

“…El linfoma gastrointestinal primario afecta principalmente el estómago, seguido de intestino delgado, colon, recto, afectación múltiple, y raramente, esófago. El linfoma representa el 0,2 % al 2 % de todas las neoplasias malignas del intestino delgado y colon, típicamente se presenta en la sexta década de la vida y es un poco más frecuente en hombres 6,7 .…”