A rare case of primary non-metastatic Non-Hodgkin's diffuse large B-cell lymphoma in the ileum in a 19-year-old male manifested as intestinal obstruction- A case report

The gastrointestinal system is the most common site for extra-nodal NHL. Adolescent population are among the rarest of compromised groups, especially males. The gastrointestinal system is more involved by secondary metastasis rather than by primary lymphomas. Cardinal B-Symptoms and obstipation cons...

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Bibliographic Details
Published in:International journal of surgery case reports 2022-01, Vol.90, p.106748-106748, Article 106748
Main Authors: Albrijawy, Reham, Al Laham, Omar, Shaheen, Jack, Atia, Fareed, Alshiekh, Ali
Format: Article
Language:English
Subjects:
Case Report
Diffuse large B-cell lymphoma
Intestinal lymphoma
Intestinal obstruction
Primary Ileal Non-Hodgkin's lymphoma
Surgical abdomen
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Summary:The gastrointestinal system is the most common site for extra-nodal NHL. Adolescent population are among the rarest of compromised groups, especially males. The gastrointestinal system is more involved by secondary metastasis rather than by primary lymphomas. Cardinal B-Symptoms and obstipation constituted the presentation of our patient who was diagnosed postoperatively as a case primary non-metastatic NHL. NHL can have misleading presentations which result in the implementation of different treatment modalities. We ought to have high clinical suspicion when presented with a patient suffering from B-Symptoms and obstipation to make timely judgements which help in performing effective therapeutic interventions to limit the morbidity and mortality which result from this pathology. We present the case of a 19-year-old male, who presented with obstipation and B-Symptoms. CT scan indicated loop dilation, a lobulated mass, and what radiologically seemed to be intussusception. Surgery was done and the resected specimens were DLBCL. We treated him by surgical excision of the affected ileal segments. Histopathology indicated a primary Non-Hodgkin's DLBCL of the ileum. Afterwards, we referred him for adjuvant chemotherapy. Treatment modalities for this malignancy are mainly surgical in addition to Chemotherapy. Intestinal extranodal NHL presents with an array of vague symptoms. As a result, this type of tumors can be clinically indistinguishable from other gastrointestinal malignancies. It is vital to keep this type of malignancy in mind as a differential diagnosis when presented with a surgical abdomen in a patient with B-Symptoms. •The gastrointestinal system is the most common occurrence site for extra-nodal Non-Hodgkin's Lymphoma.•Cardinal B-Symptoms can mislead the diagnosis as the incidence rate in such a patient demographic is undocumented.•The most frequently compromised site in the small intestine is the ileum followed by the jejunum, and the duodenum.•Primary non-metastatic NH-DLBCL is so rare in adolescent males that it warrants documentation and follow-up.•It's vital to consider this pathology when presented with obstipation and B-Symptoms in an adolescent male.
ISSN:2210-2612
2210-2612
DOI:10.1016/j.ijscr.2021.106748