Non-Hodgkin’s lymphoma revealed by an ilio-colic intussusception in a Moroccan patient: a case report

Intussusceptions are rare but well-known causes of the small bowel obstruction in adults and an underlying cause is present in the majority of cases. Lymphoma’s involvement of the ileum is one of the rare causes of intussusception. CT is a sensitive examination that diagnoses intussusceptions and provides an excellent pre-operative evaluation including possible extension and dissemination especially in intestinal lymphomas. The treatment is almost always surgical and the pathological study is needed for diagnostic confirmation. Authors present an unusual case of intestinal intussusception due to lymphoma of the terminal part of the ileum in a 49-year-old man. Computed tomography confirmed the diagnosis of intussusception and non-Hodgkin’s lymphoma of B-cell was diagnosed by histological examination after surgical treatment. Primary intestinal lymphomas differ from gastric lymphomas in clinical features, treatment, and prognosis. They are not well characterized and the standardized concepts for their clinical diagnosis and management are absent. The aim of this rare observation is to shed light on NHL of the small bowel, its clinical and radiological diagnosis and its treatment especially in forms revealed by intussusceptions in adults.

[1]  M. Moujahid,et al.  Invagination intestinale aiguë de l’adulte. À propos de trois cas , 2010 .

[2]  T. Akasu,et al.  Laparoscopic resection for malignant lymphoma of the ileum causing ileocecal intussusception. , 2007, Surgical laparoscopy, endoscopy & percutaneous techniques.

[3]  Lei Yin,et al.  Primary Small-bowel Non-Hodgkin's Lymphoma: A Study of Clinical Features, Pathology, Management and Prognosis , 2007, The Journal of international medical research.

[4]  J. M. Ramia,et al.  Linfoma primario de intestino delgado , 2007 .

[5]  J. Ramia,et al.  [Primary small bowel lymphoma]. , 2007, Cirugia espanola.

[6]  P. Minodier,et al.  Invagination intestinale aiguë de l’enfant , 2006 .

[7]  M. Mansha,et al.  Adult intussusception--a surgical dilemma. , 2006, Journal of Ayub Medical College, Abbottabad : JAMC.

[8]  F. Capron,et al.  Invagination intestinale aigu de cause inhabituelle , 2005 .

[9]  J. Tsang,et al.  Primary Follicular Lymphoma of the Small Intestine , 2004, Leukemia & lymphoma.

[10]  J. Krauss,et al.  Successful Treatment of Refractory Low Grade Duodenal Lymphoma With Rituximab, an Anti-cd20 Monoclonal Antibody , 2003, American journal of clinical oncology.

[11]  E. Thiel,et al.  Intestinal non-Hodgkin's lymphoma: a multicenter prospective clinical study from the German Study Group on Intestinal non-Hodgkin's Lymphoma. , 2003, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[12]  G. Boeckxstaens,et al.  Primary follicular lymphoma of the small intestine: alpha4beta7 expression and immunoglobulin configuration suggest an origin from local antigen-experienced B cells. , 2003, The American journal of pathology.

[13]  S. Post,et al.  Malignant Intestinal Non-Hodgkin’s Lymphoma from the Surgical Point of View , 2002, Oncology Research and Treatment.

[14]  E. Zucca,et al.  Primary intestinal diffuse large B-cell non-Hodgkin's lymphoma: clinical features, management, and prognosis of 66 patients. , 2001, Annals of oncology : official journal of the European Society for Medical Oncology.

[15]  H. Müller-Hermelink,et al.  Primary gastric B-cell lymphoma: results of a prospective multicenter study. The German-Austrian Gastrointestinal Lymphoma Study Group. , 2000, Gastroenterology.

[16]  V. Amilineni,et al.  Case 26: Jejunojejunal intussusception secondary to a lipoma. , 2000, Radiology.

[17]  A. Zinsmeister,et al.  Risk of lymphoma in inflammatory bowel disease , 2000, American Journal of Gastroenterology.

[18]  W. Scheithauer,et al.  Chemotherapy for the treatment of patients with primary high grade gastric B‐cell lymphoma of modified Ann Arbor stages IE and IIE , 2000, Cancer.

[19]  D. Liebowitz,et al.  Lymphomas in the immunocompromised patient. , 1998, Seminars in oncology.

[20]  M. Amitai,et al.  Intussusception in adults: CT diagnosis. , 1998, Clinical radiology.

[21]  B. Coiffier,et al.  Report on a workshop convened to discuss the pathological and staging classifications of gastrointestinal tract lymphoma. , 1994, Annals of oncology : official journal of the European Society for Medical Oncology.

[22]  K. Maclennan,et al.  Primary gastrointestinal non-Hodgkin's lymphoma: a review of 175 British National Lymphoma Investigation cases. , 1993, British Journal of Cancer.

[23]  R. Thirlby,et al.  Role of surgery in multimodality therapy for gastrointestinal lymphoma. , 1991, American journal of surgery.

[24]  L. Ribault,et al.  Les invaginations intestinales aiguës de l'adulte. A propos de 3 cas à l'Hôpital Principal de Dakar , 1991 .

[25]  J. Locker,et al.  The pathology of posttransplant lymphoproliferative disorders occurring in the setting of cyclosporine A-prednisone immunosuppression. , 1988, The American journal of pathology.

[26]  V. Palmieri,et al.  [Ileo-ceco-colic invagination. Apropos of a case caused by lymphoma of the last ileal loop]. , 1980, Minerva chirurgica.