Salemis Nikolaos S, Gourgiotis Stavros, Tsiambas Evangelos, Karagkiouzis Grigorios, Nakos Georgios, Karathanasis Vasilios
2nd Department of Surgery, Army General Hospital, Athens, Greece.
J Gastrointest Cancer. 2009;40(3-4):79-82. doi: 10.1007/s12029-009-9114-7.
Diffuse large B cell lymphoma is the most commonly diagnosed non-Hodgkin's lymphoma, whereas lymphoma is the most common cause of mesenteric masses. We herein present a very rare case of a young male patient with a giant diffuse large B cell lymphoma of the mesentery that was incidentally diagnosed during his admission for a road traffic accident.
At laparotomy, a huge tumor measuring 18 x 14 x 10 cm was found originating from the jejunal mesentery. Despite the giant size of the tumor, the patient was completely asymptomatic. After complete surgical recection with clear margins, he recieved six cycles of CHOP chemotherapy in the pre-rituximab era.
He remained disease-free 2 years after surgery, but unfortunately, he relapsed with disseminated disease and died 6 months later. Mesenteric lymphomas may remain asymptomatic until they reach a large size. The presence of a bulky mesenteric mass is a poor prognostic indicator.
Although chemotherapy is the treatment of choice for diffuse large B cell lymphoma, in some cases radical surgery has a role in establishing a definitive diagnosis.
弥漫性大B细胞淋巴瘤是最常被诊断出的非霍奇金淋巴瘤，而淋巴瘤是肠系膜肿块最常见的病因。我们在此报告一例非常罕见的年轻男性患者，其患有肠系膜巨大弥漫性大B细胞淋巴瘤，该病例在其因道路交通事故入院期间被偶然诊断出来。
在剖腹手术中，发现一个大小为18×14×10厘米的巨大肿瘤起源于空肠系膜。尽管肿瘤巨大，但患者完全没有症状。在进行了切缘清晰的完整手术切除后，他在利妥昔单抗时代之前接受了六个周期的CHOP化疗。
他术后2年无疾病复发，但不幸的是，他出现了播散性疾病复发，并在6个月后死亡。肠系膜淋巴瘤在体积变大之前可能一直没有症状。存在巨大的肠系膜肿块是预后不良的指标。
尽管化疗是弥漫性大B细胞淋巴瘤的首选治疗方法，但在某些情况下，根治性手术在确立明确诊断方面具有作用。
