Small intestinal plasmacytoid lymphoma. Clinical presentation with acute abdominal pain
DOI:
https://doi.org/10.31053/1853.0605.v65.n3.23566Keywords:
lymphoma, perforation, plasmacytoid configurationAbstract
Primary tumors of the small intestine are rare; 15-20% of the cases are extranodal lymphomas from B or T cells. Higher Incidence occurs in patients between 21 and 50 years. The clinical symptoms are pain, intestinal obstruction, diarrhea, bleeding or perforated peritonitis. In high-grade lymphomas, the cells are large and pleomorphic, with immunoblastic and plasmacytoid features, and immunopositive for alpha chain immunoglobulins. We reported the case of a 56-year-old patient presented with abdominal pain associated with intestinal perforation. Resections of a 9-centimetres-long segment in the small intestine was performed, which was covered by purulent plaques, with a perforation of 5 mm, surrounded by a greyish-white thick intestinal wall. It can be observed in the microscopy a proliferation of neoplastic cells arranged diffusely and with frequent mitosis. Large areas of immunoblastic and plasmacytoid configuration were evident. The immunomarcation was consistent with a lymphoma of large cells, immunophenotype B, with plasmacytoid development. We highlighted the clinical presentation like acute abdominal pain and its clinical and pathological characteristics, especially in the plasmacytoid development that should differ of the true plasmocytoma.Downloads
References
Alzubi A, Zöllei I, Krenács L, Intzédy K, Hudák J. Primary T-cell lymphoma of the small bowel. Magy Seb 2008;61:79-83.
Molina Villaverde R, Jiménez Gordo A, López González Jl, Redondo Sánchez A, Andreu Rodríguez M, González Barón M. Primary intestinal T lymphoma: a report of two cases and a review of the literature. A Med Interna 2002;199:457-9.
Fakan F, Plank L, Szépe P, Boudová L, Feit V, Námĕstek S. Intestinal T-cell lymphoma. Cesk Patol 2000;363:94-8.
Hu RJ. Pathology and prognosis of 378 cases of primary intestinal malignant lymphoma (IML). Zhonghua Zhong Liu Za Zhi 1988;10:57-60.
Matsumoto K, Chikumi Y, Otani H, Hara A, Maeda K, Yasugi A, Murawaki Y, Miura M, Koda M, Kawaguchi K, Harada K, Yashima K, Tajima F, Murawaki Y, Horie Y. Two cases of primary t cell lymphoma of the small intestine diagnosed by perforated peritonitis. Nippon Shokakibyo Gakkai Zasshi 2007;104:388-93.
Sadamura S, Chihara T, Shibata K, Nishimura J, Nawata H, Nakagaki M, Masuda Y, Ohshima K, Kikuchi M. Intestinal T-cell lymphoma (so-called malignant histiocytosis of the intestine) complicated by multiple perforations. Rinsho Ketsueki 1991;321:34-8.
Kramer W, Richter HJ. Malignant lymphoma of the small intestine as a cause of small intestine perforation. Zentralbl Chir 1994;119:900-3.
Mechat F, Zerouali ON. Non-traumatic perforation of the small intestine. J Chir (Paris). 1993;1306-7:292-6.
Yamamoto K, Shiraishi T, Ajiki T, Imai Y, Oyanagi H, Saito Y. A case of intestinal T-cell lymphoma with repeated episodes of perforation. Gastroenterol JPN 1991;265:649-53.
Remacha B, Palau A, Velicia R, CaroPatón A, Ripollés V. Primary intestinal T lymphoma. Rev Esp Enferm Dig 1998;903:183-90.
Haghighi P, Kharazmi A, Gerami C. Primary upper small lymphoma and alphachain disease. Am J Surg Pathol 1978;2:147-57.
Nassar VH, Salem Pa, Shahid MJ. Mediterranean abdominal lymphoma or immunoproliferative small intestinal disease. Cancer 1978;41:1340-54.
Pangalis GA, Rappaport H. Common clonal origin of lymphoplasmocytic proliferation and immunoblastic lymphoma and intestinal alpha-chain disease. Lancet 1977;2:880.
Li B, Shi YK, He XH, Zou SM, Zhou SY, Dong M, Yang JL, Liu P, Xue LY. Primary non-Hodgkin lymphomas in the small and large intestine: clinicopathological characteristics and management of 40 patients. Int J Hematol 2008;87:375-81
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