Zaarour Mazen, Busack Christopher, Munker Reinhold
Hematology and Oncology, Tulane University School of Medicine, New Orleans, USA.
Internal Medicine, Tulane University School of Medicine, New Orleans, USA.
Cureus. 2019 May 8;11(5):e4621. doi: 10.7759/cureus.4621.
Primary small bowel tumors are uncommon and usually carry a poor prognosis. Adenocarcinoma is the predominant histological type while lymphoma is far less common. Small bowel diffuse large B-cell lymphoma (DLBCL) can mimic adenocarcinoma; thus, the distinction can be challenging before tissue examination is performed. Bowel obstruction, as well as peritoneal involvement, are often seen in gastrointestinal (GI) adenocarcinoma cases; however, these features are extremely uncommon with GI lymphomas. Herein, the authors report an unusual case of an obstructing duodenal mass with peritoneal involvement, which was highly suspicious for an advanced duodenal adenocarcinoma. Surprisingly, sampling of the tumor revealed a diffuse large B-cell lymphoma.
原发性小肠肿瘤并不常见，通常预后较差。腺癌是主要的组织学类型，而淋巴瘤则远没有那么常见。小肠弥漫性大B细胞淋巴瘤（DLBCL）可能会与腺癌相似；因此，在进行组织检查之前，鉴别诊断可能具有挑战性。肠梗阻以及腹膜受累在胃肠道（GI）腺癌病例中经常可见；然而，这些特征在胃肠道淋巴瘤中极为罕见。在此，作者报告了一例罕见病例，该病例为十二指肠肿物伴梗阻及腹膜受累，高度怀疑为晚期十二指肠腺癌。令人惊讶的是，肿瘤取样显示为弥漫性大B细胞淋巴瘤。
