Maruo Hirotoshi, Tsuyuki Hajime, Shimizu Yuji, Shibasaki Yasushi, Nakamura Koichi, Higashi Yukihiro, Shoji Tsuyoshi, Hirayama Kazuhisa, Yamazaki Masanori
Dept. of Surgery, Shizuoka City Shimizu Hospital.
Gan To Kagaku Ryoho. 2018 Dec;45(13):1886-1888.
We report the cases we encountered in our department involving 4 patients with malignant ilial lymphoma that caused ileocolic intussusception. The patients were 2 male and 2 female, aged 65-76 years. All patients' chief complaint was abdominal pain. Computed tomography revealed target signs characteristic of intussusception. Colonoscopy showed a tumor that escaped into the colon, leading to the diagnosis of ileocolic intussusception due to an ileal tumor. However, definitive diagnosis could not be achieved from biopsy. Thus, ileocecal resection or right hemicolectomy was performed. Macroscopically, all tumors were polypoid type and were present within 25 cm from the valve of Bauhin. Histological diagnoses were diffuse large B-cell lymphoma(DLBCL)in 2 patients, T-cell lymphoma in one, and follicular lymphoma in one. Postoperative chemotherapy was performed in patients with DLBCL and T-cell lymphoma. Tumors are commonly the cause of intussusception in adults; therefore, emergent surgery is imperative. When malignant lymphoma is diagnosed, a multidisciplinary approach that includes postoperative chemotherapy is necessary.
我们报告了在我科遇到的4例因恶性回肠淋巴瘤导致回结肠套叠的病例。患者为2男2女,年龄65 - 76岁。所有患者的主要症状均为腹痛。计算机断层扫描显示出套叠的特征性靶征。结肠镜检查发现肿瘤延伸至结肠,从而诊断为回肠肿瘤导致的回结肠套叠。然而,活检未能明确诊断。因此,实施了回盲部切除术或右半结肠切除术。肉眼观察,所有肿瘤均为息肉样,位于距回盲瓣25 cm范围内。组织学诊断为2例弥漫性大B细胞淋巴瘤(DLBCL),1例T细胞淋巴瘤,1例滤泡性淋巴瘤。DLBCL和T细胞淋巴瘤患者术后接受了化疗。肿瘤通常是成人套叠的病因;因此,紧急手术势在必行。当诊断为恶性淋巴瘤时,需要采用包括术后化疗在内的多学科治疗方法。