Karthikeyan Raveena, Sakthivel H, Rajkumar N, Srinivasan K
Department of General Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Niger J Surg. 2021 Jan-Jun;27(1):71-74. doi: 10.4103/njs.NJS_55_19. Epub 2021 Mar 9.
Interdigitating dendritic cell sarcoma (IDCS) is an extremely rare neoplasm arising from the antigen-presenting cells of the immune system. It usually involves the lymph nodes, and extranodal sites are rarely affected. Here, we report a first known case of spontaneous hemoperitoneum caused by the rupture of IDCS of the small bowel. A 61-year-old male presented with complaints of abdominal pain and fever for 3 days and breathlessness for 1 day. Ultrasound abdomen revealed a 15 cm × 7 cm heterogeneous collection with thick septations in the periumbilical region. Diagnostic peritoneal lavage revealed hemoperitoneum and gangrenous bowel. Emergency laprotomy was done and it revealed a friable mass arising from the ileum. Resection of 2 ft of the ileum and double-barrel ileostomy was done. Immunohistochemical analysis revealed a positivity of S100 and leukocyte common antigen). A diagnosis of IDCS was made. The patient had an uneventful postoperative recovery and planned for postoperative chemotherapy.
指状突树突状细胞肉瘤（IDCS）是一种极其罕见的肿瘤，起源于免疫系统的抗原呈递细胞。它通常累及淋巴结，结外部位很少受累。在此，我们报告首例已知的由小肠IDCS破裂导致的自发性血腹病例。一名61岁男性，主诉腹痛、发热3天，气促1天。腹部超声显示脐周区域有一个15厘米×7厘米的不均匀液性包块，伴有厚分隔。诊断性腹腔灌洗显示血腹和坏疽性肠管。遂行急诊剖腹探查术，发现回肠有一质脆肿块。切除2英尺回肠并行双腔回肠造口术。免疫组织化学分析显示S100和白细胞共同抗原呈阳性。确诊为IDCS。患者术后恢复顺利，计划接受术后化疗。
