Panaccio Paolo, Fiordaliso Michele, Testa Domenica, Mazzola Lorenzo, Battilana Mariangela, Cotellese Roberto, Selvaggi Federico
Department of Medical and Oral Sciences and Biotechnologies, "G. d'Annunzio" University, Chieti, Italy.
General Surgery Unit, Renzetti Hospital, Lanciano, Italy.
Case Rep Surg. 2018 Apr 30;2018:6265182. doi: 10.1155/2018/6265182. eCollection 2018.
Primary NHL (non-Hodgkin lymphoma) of the colon represents only 0.2% to 1.2% of all colonic malignancies. Burkitt's lymphoma (BL) is usually a disease reported in children and young people, most of them associated with EBV or HIV infection. We describe a rare case of intestinal obstruction due to sporadic Burkitt's lymphoma causing ileocaecal invagination explaining our experience . A 31-year-old man presented with diffuse colic pain and weight loss. Clinical examination revealed an abdominal distension with pain in the right iliac fossa. Colonoscopy documented a caecal large lesion with ulcerated mucosa. Computed tomography (CT) have shown a 60 × 50 mm right colic parietal lesion with signs of ileocolic intussusception.
Laparoscopic right hemicolectomy was performed. Postoperative period was uneventful. CD20+ high-grade B-cell Burkitt's lymphoma was confirmed by immunohistochemistry (CD20+, CD79+, and CD10+) and FISH test (t (8;14) (q24; q32). The patient was subsequently treated with adjuvant combination chemotherapy (Hyper-CVAD) and is alive and disease-free at 8 months follow-up.
Adult sporadic Burkitt's lymphoma (BL) causing intestinal obstruction due to ileocaecal intussusception is an extremely rare occurrence and a diagnostic dilemma. Despite the surgical approach is selected based on patient's conditions and surgeon's expertise, minimally invasive method could be preferred.
结肠原发性非霍奇金淋巴瘤（NHL）仅占所有结肠恶性肿瘤的0.2%至1.2%。伯基特淋巴瘤（BL）通常是一种在儿童和年轻人中报道的疾病，其中大多数与EBV或HIV感染有关。我们描述了一例罕见的因散发性伯基特淋巴瘤导致回盲部套叠而引起肠梗阻的病例，并阐述我们的经验。一名31岁男性出现弥漫性绞痛和体重减轻。临床检查发现腹部膨隆，右下腹疼痛。结肠镜检查发现盲肠有一个大病变，黏膜溃疡。计算机断层扫描（CT）显示右结肠壁有一个60×50mm的病变，有回结肠套叠的迹象。
进行了腹腔镜右半结肠切除术。术后恢复顺利。免疫组织化学（CD20 +、CD79 +和CD10 +）和荧光原位杂交检测（t（8；14）（q24；q32））确诊为CD20 +高级别B细胞伯基特淋巴瘤。患者随后接受了辅助联合化疗（Hyper - CVAD），在8个月的随访中存活且无疾病。
成人散发性伯基特淋巴瘤（BL）因回盲部套叠导致肠梗阻是一种极其罕见的情况，也是一个诊断难题。尽管手术方式是根据患者情况和外科医生的专业知识选择的，但微创方法可能更可取。
