Vasudevan Jayasudha Arundhathi, Nair Rekha A, Nambiar K Rakul
Division of Pathology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India.
Division of Medical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India.
Indian J Pathol Microbiol. 2017 Jul-Sep;60(3):412-414. doi: 10.4103/IJPM.IJPM_767_16.
Hodgkin lymphoma (HL) commonly presents as nodal disease, but in a subset of cases, the disease primarily develops in extranodal sites. Primary classical HL of the gastrointestinal (GI) tract is an extremely rare occurrence. Primary nature of the disease is confirmed after a complete lymphoma work up including chest radiograph, computed tomography scan, peripheral blood, and bone marrow studies. Only a few cases of primary GI lymphomas with limited immunohistochemical or molecular confirmation have been reported in literature. We report the case of a 64-year-old immunocompetent woman with primary rectal HL. She presented with constipation, and on sigmoidoscopy examination, she was detected to have an ulceroproliferative circumferential growth in the rectum. Considering the possibility of rectal carcinoma, a low anterior resection was done. Histology was suggestive of mixed cellularity classical HL. She was started on combination chemotherapy, and she responded well to treatment. However, she developed pulmonary complication after the fourth cycle of chemotherapy and succumbed to the illness. Primary rectal HL is extremely rare, and to the best of our knowledge, only 16 cases have been reported previously. We believe that reporting this case will add to the scarce data about this unusual presentation in immunocompetent patients.
霍奇金淋巴瘤（HL）通常表现为淋巴结疾病，但在一部分病例中，该疾病主要发生在结外部位。胃肠道（GI）原发性经典型HL极为罕见。在完成包括胸部X线、计算机断层扫描、外周血和骨髓检查在内的全面淋巴瘤检查后，方可确诊该疾病的原发性。文献中仅报道了少数几例经有限免疫组化或分子检测确诊的原发性胃肠道淋巴瘤病例。我们报告一例64岁免疫功能正常的女性原发性直肠HL病例。她因便秘就诊，乙状结肠镜检查发现直肠有溃疡性增生性环周肿物。考虑到直肠癌的可能性，行低位前切除术。组织学检查提示为混合细胞型经典型HL。她开始接受联合化疗，治疗反应良好。然而，化疗第四周期后出现肺部并发症，最终病逝。原发性直肠HL极为罕见，据我们所知，此前仅报道过16例。我们认为，报告该病例将为免疫功能正常患者中这种不寻常表现的稀缺数据增添内容。
