Jejunocolic Fistula Associated with an Intestinal T Cell Lymphoma

Abstract

Malignant fistula of the small bowel to the colon is rare and is most often due to adenocarcinoma. Small bowel lymphoma is unusual, representing less than 1 percent of all gastrointestinal malignancies. We report a case of intestinal lymphoma presenting with diarrhea and abdominal pain. A jejunocolic fistula was discovered during colonoscopy. Celiotomy revealed a large, ulcerated fistula tract between the jejunum and distal transverse colon, and pathology was consistent with peripheral T-cell lymphoma. This is a rare entity in a nonimmunocompromised individual and has not been previously described in Korea.

Ileo-Colonic Fistula Due to Diffuse Large B Cell Lymphoma: Unusual Presentation of a Rare Disease

“…Malignant ileo-colonic fistula is occasionally associated with adenocarcinoma of the cervix, ovaries and colon [ 7 , 8 ]. In 1862, the first case of malignant gastrointestinal fistula secondary to a cecal adenocarcinoma was reported, but it was not until 1946 that a fistula due to primary gastrointestinal (GI) lymphoma was described [ 9 , 10 ].…”

“…Small bowel lymphoma is reported as the cause of less than one percent of all gastrointestinal malignancies, and in the absence of prior chemotherapy, surgical resection, or recent radiotherapy, the development of fistula is extraordinarily rare [ 7 ]. Nine primary lymphoma cases causing entero-colic fistula have been reported in literature; six are of B cell origin and three of T cell origin [ 6 , 7 , 11 ].…”

“…Although mostly a nodal disease, 40% of cases of DLBCL involve extranodal sites such as the gastrointestinal tract [ 4 , 5 ]. Tumor intestinal fistulas are rare but serious complications of advanced primary intestinal lymphoma like DLBCL, with a paucity of reported cases [ 6 , 7 ]. We present a case of an ileo-colonic fistula due to primary DLBCL of the ileum in a 55-year-old male, followed by a case discussion and literature review.…”

An ileosigmoid fistula: what is the diagnosis?

“…Intestinal perforation can occur spontaneously, act as a surgical complication, or arise from the regressive changes after chemotherapy, which may result in chronic GI fistulas occasionally. Primary GI fistulas that communicate with the guts and various adjacent organs have also been documented, including the bronchus, bladder, spleen, and even aorta 345…”

“…Primary GI fistulas that communicate with the guts and various adjacent organs have also been documented, including the bronchus, bladder, spleen, and even aorta. 3 4 5 …”