Second Department of Internal Medicine, Osaka Medical College, Japan.
Department of Pathology, Osaka Medical College, Japan.
Intern Med. 2021 Feb 1;60(3):397-402. doi: 10.2169/internalmedicine.5516-20. Epub 2020 Aug 29.
A 74-year-old man presented with abdominal swelling. Computed tomography revealed massive ascites and localized thickening of the small intestinal wall. Enteroscopy showed ulcerative lesions along the circumference of the jejunum. Histological examination showed dense proliferation of large lymphoid atypical cells, and immunohistochemistry showed CD20 and CD10 positivity, CD3 negativity, and Ki67 labeling index >80%. Cytology of the ascitic fluid revealed large lymphoid cells. These findings suggest that small intestine primary diffuse large B-cell lymphoma (DLBCL) caused the ascites. Massive ascites as an initial symptom of primary DLBCL of the jejunum is rare. Herein, we describe this unusual presentation.
一位 74 岁男性因腹部肿胀就诊。计算机断层扫描显示大量腹水和小肠壁局部增厚。内镜检查显示空肠沿其圆周有溃疡性病变。组织学检查显示大淋巴样异型细胞密集增生，免疫组化显示 CD20 和 CD10 阳性，CD3 阴性，Ki67 标记指数>80%。腹水细胞学检查显示大淋巴细胞。这些发现提示小肠原发性弥漫性大 B 细胞淋巴瘤（DLBCL）导致腹水。以大量腹水为首发症状的空肠原发性 DLBCL 较为罕见。本文描述了这一不常见的表现。
