Giroux Parker, Collier Anderson, Nowicki Michael
Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS 39216, United States.
Division of Pediatric Hematology and Oncology, University of Mississippi Medical Center, Jackson, MS 39216, United States.
World J Clin Cases. 2020 Jan 26;8(2):306-312. doi: 10.12998/wjcc.v8.i2.306.
The clinical presentation of acute lymphoblastic lymphoma is highly varied. While prognosis is good, recurrence of disease can occur. Gastrointestinal relapse, including intussusception, is well-described but the absence of abdominal pain in this setting is rare.
We report a 13-year-old male with B-cell precursor acute lymphoblastic leukemia in remission presenting with anemia and weight loss. Examination was significant for absence of abdominal pain, but a stool sample was positive for occult blood. Pan-endoscopy was performed with colonoscopy revealing a mass filling the colonic lumen. Biopsy of the mass confirmed recurrence of recurrent B-cell lymphoma. Computed tomography scan revealed ileocolic intussusception resulting from the tumor. This case is unusual in that the patient had no abdominal pain despite the presence of intussusception.
While intestinal involvement with lymphoma has been well described in the literature, presentation as painless intussusception has not been reported. This case report highlights the wide spectrum of clinical manifestations of recurrent B-cell lymphoma involving the gastrointestinal tract, in particular the near absence of symptoms despite the finding of intussusception.
急性淋巴细胞淋巴瘤的临床表现高度多样。虽然预后良好，但疾病仍可能复发。胃肠道复发，包括肠套叠，已有详细描述，但在此情况下无腹痛的情况罕见。
我们报告一名13岁男性，患有处于缓解期的B细胞前体急性淋巴细胞白血病，出现贫血和体重减轻。检查发现无腹痛，但粪便潜血试验呈阳性。进行了全内镜检查，结肠镜检查发现一个肿块充满结肠腔。肿块活检证实为复发性B细胞淋巴瘤复发。计算机断层扫描显示肿瘤导致回结肠套叠。该病例不同寻常之处在于，尽管存在肠套叠，但患者没有腹痛。
虽然淋巴瘤累及肠道在文献中已有充分描述，但以无痛性肠套叠形式出现尚未见报道。本病例报告强调了复发性B细胞淋巴瘤累及胃肠道的广泛临床表现，特别是尽管发现肠套叠但几乎没有症状。
