Primary stomal lymphoma. An unusual complication of ileostomy in a patient with transfusion-related acquired immune deficiency syndrome

Levecq, H; Hautefeuille, M; Hoang, Catherine; Galian, A; Hautefeuille, P; Rambaud, Jean–Claude

doi:10.1002/1097-0142(19900215)65:4<1028::aid-cncr2820650431>3.0.co;2-y

Cited by 12 publications

(4 citation statements)

References 26 publications

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“…4 A previous study reported positive associations between DLBCL and rheumatoid arthritis, Sjogren syndrome, systemic lupus erythematosus, and celiac disease. 5 Inflammatory bowel disease, 6 prolonged use of azathioprine or 6-mercaptopurine, 7 human immunodeficiency virus infection, 8 and congenital or acquired immunodeficiencies 9 have been reported to be the risk factors for lymphoma development at the stoma of the digestive tract. Muta et al reported that long-term inflammation or immunodeficiencies might be the underlying risk factors for the occurrence of lymphomas, 1 such as the one mentioned in our case.…”

Section: Discussionmentioning

confidence: 99%

Primary diffuse large B‐cell lymphoma of the ileal conduit created after radical cystectomy

et al. 2018

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Introduction Creation of an ileal conduit is associated with complications. A few cases have been reported on tumor development in an ileal conduit; diffuse large B‐cell lymphoma originating from an ileal conduit is extremely rare. Case presentation A 62‐year‐old Japanese man who had undergone radical cystectomy and ileal conduit diversion 6 years previously presented with a whitish bulge that had developed on the surface of the ileal conduit during follow‐up visit. Mass biopsy was performed and the histological diagnosis was diffuse large B‐cell lymphoma. Positron emission tomography showed no metastatic lesions. We attempted chemotherapy because the tumor cells tested positive for CD20; after six courses of a regimen involving rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone; diffuse large B‐cell lymphoma of the ileal conduit resolved gradually. The patient is alive and remains free from the diagnosed diffuse large B‐cell lymphoma. Conclusion We reported an extremely rare case of diffuse large B‐cell lymphoma originating from the ileal conduit created after radical cystectomy.

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Section: Discussionmentioning

confidence: 99%

Primary diffuse large B‐cell lymphoma of the ileal conduit created after radical cystectomy

et al. 2018

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“…The long term use of azathioprine or 6-MP also contributes to the risk of lymphoma (8): one patient with EBV-positive lymphoma at the ileal pouch received 6-MP for decades (3). Another patient was infected with human immunodeficiency virus (6). Congenital or acquired immunodeficiencies are also likely to be complicated with lymphoma (9).…”

Section: Discussionmentioning

confidence: 99%

“…As a surgical treatment for inflammatory bowel disease, the ileum is used to form a reservoir for stools or a stoma after colonectomy. Even under such circumstances, lymphomas can arise primarily in the ileal pouch or stoma (2)(3)(4)(5)(6). Concerning bladder reconstruction using an ileal conduit, this is the first reported case of lymphoma that developed primarily at the stoma.…”

Section: Introductionmentioning

confidence: 97%

Diffuse Large B-cell Lymphoma Arising Primarily at the Stoma After Bladder Reconstruction Using Ileal Conduit

et al. 2012

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A 76-year-old man suffered from swelling stoma for several weeks. A biopsy sample revealed the diffuse infiltration of large lymphoid cells which were positive for CD20, bcl-6, and MUM1. The patient was diagnosed with diffuse large B-cell lymphoma, with a non-germinal center B-cell pattern. A whole-body PET-CT scan revealed that the lymphoma was restricted to the stomal site. Bladder reconstruction was undertaken using the ileal conduit: this is the first reported case of lymphoma that developed primarily at the stoma. During the long-term maintenance after bladder reconstruction, clinicians should consider the possibility of lymphoma at the stomal site.

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“…2 Adenocarcinoma of the small intestine is rare compared with other sites in the gastrointestinal tract. Of the four major primary small bowel tumours (adenocarcinomas, lymphomas, carcinoid, and leiomyosarcomas), the former two are associated with diseases that seem to increase the risk of developing these malignancies.…”

Section: Discussionmentioning

confidence: 99%

Lymphoma in an ileostomy

Nigam¹

2002

Postgraduate Medical Journal

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Lymphoma developing in an ileostomy is an extremely rare complication. The presentation is similar to the commoner, yet still rare, adenocarcinoma but the staging and management of the condition differs.A 78 year old man was referred to the surgical outpatient clinic by the stoma care clinical nurse specialist. He was having increasing difficulties with his long standing right iliac fossa end ileostomy that had been created 20 years earlier for ulcerative colitis. He noticed that it was functioning but prolapsed, extending to approximately 10 cm from the skin surface. It was very hard, swollen with a diameter of 6.4 cm, with the tip appearing bruised and black, stenosed, and bleeding to the touch. These changes had occurred over a six month period and been associated with several episodes of bleeding. It was painless but he was having great difficulty in obtaining a satisfactory seal with the stoma appliances. His weight was steady and his appetite good. He was a hypertensive on treatment and was otherwise well.Examination confirmed the above findings of a swollen, necrotic, and stenosed stoma (see fig 1) and also revealed two skin deposits adjacent to the stoma and a large parastomal hernia. A clinical diagnosis of a malignant change in an ileostomy was made and after discussion with the patient, a decision to undertake an en-bloc excision and refashioning of the stoma was made. A preoperative biopsy was not carried out as it was felt that it would not change the above management plan.A midline laparotomy was carried out to clinically stage the disease. No obvious mesenteric or para-aortic nodal enlargement was detected. The liver and spleen were impalpable due to adhesions. The ileostomy was excised en-bloc with the abdominal wall through a transverse elliptical incision. A new end ileostomy was fashioned in the left iliac fossa.Histology revealed a B-cell non-Hodgkins lymphoma of the ileum. The tumour appeared to have been completely excised.Standard staging tests showed that the tumour appeared to be localised. In view of its large size and grade II histology and hence a high probability of occult disease, chemotherapy was offered with PACEBO (prednisolone, Adriamycin, cyclophosphamide, etoposide, bleomycin, and oncovin), an eight week protocol discussed by the British National Lymphoma Investigation for elderly patients with non-Hodgkin's lymphoma.

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Primary stomal lymphoma. An unusual complication of ileostomy in a patient with transfusion-related acquired immune deficiency syndrome

Cited by 12 publications

References 26 publications

Primary diffuse large B‐cell lymphoma of the ileal conduit created after radical cystectomy

Primary diffuse large B‐cell lymphoma of the ileal conduit created after radical cystectomy

Diffuse Large B-cell Lymphoma Arising Primarily at the Stoma After Bladder Reconstruction Using Ileal Conduit

Lymphoma in an ileostomy

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