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MAP  >  Gastrointestinal Tumors
2021 Volume 8
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CASE REPORT   Open Access    

Common Presentation of an Uncommon Small Intestinal Lymphoma: A Rare Case Entity

  • a.

    Department of Pathology, All India Institute of Medical Sciences, Jodhpur, India

  • b.

    Department of General Surgery, All India Institute of Medical Sciences, Jodhpur, India

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  • Corresponding author: Jyotsna Naresh Bharti Department of Pathology All India Institute of Medical Sciences Basni Phase Ⅱ, Jodhpur 342005 (India) Jyotsnamamc@gmail.com 
  • Primary gastrointestinal NHL accounts for 30–40% of all extranodal NHL. Primary gastrointestinal lymphomas constitute 5% of total gut neoplasms. Bowel perforation is a severe life-threatening complication and sometimes initial presentation of gastrointestinal lymphoma. A 60-year-old man presented with complaints of abdominal pain, distension, nausea and vomiting. There was clinical suspicion of acute intestinal perforation, which was confirmed by radiology. The patient underwent emergency laparotomy. The resected bowel on histopathological examination and immunohistochemistry was diagnosed as the high-grade transformation of follicular lymphoma (FL). The patient received 6 cycles of chemotherapy and is doing well at 3 years of follow-up. Herein, we report this rare malignancy of the small intestine. FL mostly presents as a nodal disease but also involves the extranodal sites. The most common site of primary gastrointestinal-follicular lymphoma (GI-FL) is the small intestine. The cellular and molecular characteristic of GI-FL is different from that of the nodal FL. Extranodal FL is usually localized, but the prognosis of transformed FL is low, and these are managed by surgery followed by chemotherapy. High clinical suspicion and extensive sampling of perforated bowel are essential to diagnose the high-grade transformation of FL.

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    Sushma Bharti, Jyotsna Naresh Bharti, Mahendra Lodha. 2021. Common Presentation of an Uncommon Small Intestinal Lymphoma: A Rare Case Entity. Gastrointestinal Tumors. 8:512246 doi: 10.1159/000512246
    Sushma Bharti, Jyotsna Naresh Bharti, Mahendra Lodha. 2021. Common Presentation of an Uncommon Small Intestinal Lymphoma: A Rare Case Entity. Gastrointestinal Tumors. 8:512246 doi: 10.1159/000512246
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Case Report   Open Access    

Common Presentation of an Uncommon Small Intestinal Lymphoma: A Rare Case Entity

  • a.

    Department of Pathology, All India Institute of Medical Sciences, Jodhpur, India

  • b.

    Department of General Surgery, All India Institute of Medical Sciences, Jodhpur, India

  • Corresponding author: Jyotsna Naresh Bharti Department of Pathology All India Institute of Medical Sciences Basni Phase Ⅱ, Jodhpur 342005 (India) Jyotsnamamc@gmail.com 
  • Received: 13 July 2020
  • Accepted: 08 October 2020
  • Published online: 17 February 2021
Gastrointestinal Tumors  8,  Article number: 10.1159/000512246  (2021)  |  Cite this article

Abstract: Primary gastrointestinal NHL accounts for 30–40% of all extranodal NHL. Primary gastrointestinal lymphomas constitute 5% of total gut neoplasms. Bowel perforation is a severe life-threatening complication and sometimes initial presentation of gastrointestinal lymphoma. A 60-year-old man presented with complaints of abdominal pain, distension, nausea and vomiting. There was clinical suspicion of acute intestinal perforation, which was confirmed by radiology. The patient underwent emergency laparotomy. The resected bowel on histopathological examination and immunohistochemistry was diagnosed as the high-grade transformation of follicular lymphoma (FL). The patient received 6 cycles of chemotherapy and is doing well at 3 years of follow-up. Herein, we report this rare malignancy of the small intestine. FL mostly presents as a nodal disease but also involves the extranodal sites. The most common site of primary gastrointestinal-follicular lymphoma (GI-FL) is the small intestine. The cellular and molecular characteristic of GI-FL is different from that of the nodal FL. Extranodal FL is usually localized, but the prognosis of transformed FL is low, and these are managed by surgery followed by chemotherapy. High clinical suspicion and extensive sampling of perforated bowel are essential to diagnose the high-grade transformation of FL.

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    Cite this article
    Sushma Bharti, Jyotsna Naresh Bharti, Mahendra Lodha. 2021. Common Presentation of an Uncommon Small Intestinal Lymphoma: A Rare Case Entity. Gastrointestinal Tumors. 8:512246 doi: 10.1159/000512246
    Sushma Bharti, Jyotsna Naresh Bharti, Mahendra Lodha. 2021. Common Presentation of an Uncommon Small Intestinal Lymphoma: A Rare Case Entity. Gastrointestinal Tumors. 8:512246 doi: 10.1159/000512246
    shu

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