Koo Tae Hyoung, Choi Won Jong, Han Seung Hee, Kim Su Young, Lee Jong Hun
Department of Internal Medicine, Dong-A Universitiy College of Medicine, Busan, Korea.
Korean J Gastroenterol. 2015 Apr;65(4):241-5. doi: 10.4166/kjg.2015.65.4.241.
A 66-year-old male with dyspepsia and weight loss was referred to our hospital for evaluation. On laboratory examination, anti-saccharomyces cerevisiae (ASCA)-IgA was positive and iron deficiency anemia was present. PET/CT and abdominal CT scan images showed multiple small bowel segmental wall thickening and inflammation. Capsule endoscopy images showed multiple small bowel ulcerative lesions with exudates. Based on laboratory test results and imaging studies, the patient was diagnosed with Crohn's disease and treated with prednisolone and 5-aminosalicylic acid (5-ASA). However, the patient underwent second operation due to small bowel perforation within 2 month after initiation of treatment. Pathology report of the resected specimen was compatible to primary small bowel diffuse large B cell lymphoma and pertinent treatment was given to the patient after recovery. Herein, we describe a case of primary small bowel diffuse large B cell lymphoma that was mistaken for Crohn's disease.
一名66岁男性，有消化不良和体重减轻症状，被转诊至我院进行评估。实验室检查显示，抗酿酒酵母（ASCA）-IgA呈阳性，且存在缺铁性贫血。PET/CT和腹部CT扫描图像显示多个小肠节段性肠壁增厚及炎症。胶囊内镜图像显示多个小肠溃疡性病变伴渗出物。根据实验室检查结果和影像学研究，该患者被诊断为克罗恩病，并接受泼尼松龙和5-氨基水杨酸（5-ASA）治疗。然而，患者在治疗开始后2个月内因小肠穿孔接受了二次手术。切除标本的病理报告与原发性小肠弥漫性大B细胞淋巴瘤相符，患者康复后接受了相关治疗。在此，我们描述一例被误诊为克罗恩病的原发性小肠弥漫性大B细胞淋巴瘤病例。
