Lymphoma presenting as small bowel obstruction: A case report

Imrani, Kaoutar; Lahfidi, Amal; Belkouchi, Lina; Jerguigue, Hounayda; Latib, Rachida; Omor, Youssef

doi:10.1016/j.radcr.2020.12.044

Cited by 5 publications

(6 citation statements)

References 6 publications

(9 reference statements)

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“…[6][7][8][9] We described a wide range of clinical presentations, from asymptomatic patients to acute surgical complications. In fact, small bowel lymphomas seem to have a predilection to present in a complicated fashion, as occurred in 35% of patients in our study and supported by previous cases presenting with perforation, 15 intestinal obstruction, 16 ileal intussusception, 17 gastrointestinal bleeding, 18 obstructive jaundice, 19 or acute pancreatitis. 20 However, they are also often detected incidentally in asymptomatic patients 21 or during workup for mild dyspeptic symptoms.…”

Section: Discussionsupporting

confidence: 90%

Clinicopathological characteristics and prognostic factors of small bowel lymphomas: a retrospective single-center study

Dias¹,

Medas²,

Marques³

et al. 2023

Porto Biomedical Journal

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Background:There is little information on diagnosis and management of small bowel lymphomas, and optimal management strategies are still undefined. This study aims to describe their main clinical and pathological characteristics and identify poor prognostic factors.Methods:A retrospective observational study of all patients with histological diagnosis of small bowel lymphoma between January 2010 and December 2020 was performed.Results:We included 40 patients, with male predominance (60%) and mean age of 60.7 years. The ileum was the most common location, and the most common histological subtypes were follicular lymphoma and diffuse large B-cell lymphoma. Clinical presentation was variable from asymptomatic patients (30%) to acute surgical complications (35%) including perforation, intestinal obstruction, ileal intussusception, or severe bleeding. Diagnosis was established by endoscopy in 22 patients (55%), and the most common findings included polyps, single mass, diffuse infiltration, or ulceration, whereas 18 (45%) required surgery because of acute presentations or tumor resection, and lymphoma was diagnosed postoperatively. Surgery was curative in one-third of those patients. Median survival was 52 months. Acute presentation (P = 0.001), symptomatic disease (P = 0.003), advanced stage (P = 0.008), diffuse large B-cell lymphoma (P = 0.007), anemia (P = 0.006), hypoalbuminemia (P < 0.001), elevated lactate dehydrogenase (P = 0.02), elevated C-reactive protein (P < 0.001), and absence of treatment response (P < 0.001) were significant predictors of mortality.Conclusion:Small bowel lymphoma is a rare malignancy with diverse clinical and endoscopic presentations that require a high index of suspicion. Primary factors associated with worse outcome included acute presentation, advanced stage, histological subtype, biochemical abnormalities, and absence of treatment response.

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Section: Discussionsupporting

confidence: 90%

Clinicopathological characteristics and prognostic factors of small bowel lymphomas: a retrospective single-center study

Dias¹,

Medas²,

Marques³

et al. 2023

Porto Biomedical Journal

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“…This can result in intestinal occlusion due to extrinsic compression, with or without infiltration of adjacent loops. However, this remains a very rare consequence of lymphoma due to the absence of a desmoplastic reaction [20] . The CT scan should also look for signs of severe occlusion.…”

Section: Discussionmentioning

confidence: 99%

“…The main differential diagnoses are adenocarcinoma of the small intestine and thickening of the intestinal wall of infectious or inflammatory origin, notably ileocaecal tuberculosis. However, certain criteria can guide the diagnosis; in the case of lymphoma, parietal thickening is circumferential segmental or multi-segmental, moderately enhanced, and the junction with the normal intestinal segment is progressive [20 , 21] . The slight enhancement of the wall and the discreet infiltration of fat led us to this diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Burkitt's lymphoma revealed by intestinal obstruction: A case report

Kessi,

Guelzim,

Bennani

et al. 2024

Radiology Case Reports

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“…Some complications can develop if small bowel lymphoma is left untreated, and they can manifest as the initial presentation. Based on many reports, these complications include bleeding, obstruction, and perforation [18][19][20]. Perforation of the small bowel is a serious emergency that can rapidly lead to sepsis and a high mortality rate [21].…”

Section: Discussionmentioning

confidence: 99%

Small Bowel Lymphoma Complicated With Ischemic Colitis: A Case Report

Inban,

Carredo,

Arslan

et al. 2023

Cureus

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Ischemic colitis is thought to be an injury to the colon as a result of reduced blood flow. Certain infectious diseases such as the Epstein-Barr virus can aid in the reduction of blood flow. The insult can range from inflammation and superficial injury to full-thickness necrosis. The typical regions affected are the “watershed” areas of the colon: the splenic flexure, the rectosigmoid junction, and the right colon. Because patients can present with a wide spectrum of symptoms from vague abdominal discomfort to complete abdominal catastrophe, the diagnosis of ischemic colitis is sometimes challenging to make. Patients typically present with the acute onset of crampy abdominal pain and usually pass blood mixed with stool within 24 hours. Endoscopically, ischemia is suspected in the presence of bluish hemorrhagic nodules from submucosal bleeding, cyanotic or necrotic mucosa with bleeding ulcerations, or a segmental distribution with an abrupt transition point between injured and normal mucosa. We present a case of an 80-year-old male with a history of hypertension, hyperlipidemia, and basal cell carcinoma of the scalp diagnosed with ischemic colitis associated with positive Epstein-Barr virus B cell lymphoma.

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Lymphoma presenting as small bowel obstruction: A case report

Cited by 5 publications

References 6 publications

Clinicopathological characteristics and prognostic factors of small bowel lymphomas: a retrospective single-center study

Clinicopathological characteristics and prognostic factors of small bowel lymphomas: a retrospective single-center study

Burkitt's lymphoma revealed by intestinal obstruction: A case report

Small Bowel Lymphoma Complicated With Ischemic Colitis: A Case Report

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