Sierra Gabarda Olivia, Aguirre Portu Nerea, Casas Deza Diego, Lamuela Calvo Luis Javier, Betoré Glaría Elena, Julián Gomara Belén, Abecia Martínez Emilio Ignacio, Fernández Bonilla Eva María
Aparato Digestivo, Hospital Universitario Miguel Servet.
Medicina Interna, Hospital Universitario Miguel Servet.
Rev Esp Enferm Dig. 2022 Nov;114(11):692. doi: 10.17235/reed.2022.8765/2022.
We present the case of a 37-year-old Caucasian woman, with no history of interest, who came to the emergency room for an occlusive condition of 24 hours' evolution. The patient reported a weight loss of 12 kg in the last month, as well as the appearance of a lump in the left breast in the last week. A chest-abdominal CT scan revealed multiple solid-appearing nodules in the left breast, a metastatic liver lesion, and a tumor-like mass in the right iliac fossa measuring 90x60 mm. A biopsy of the breast lesion revealed a diffuse architectural pattern with destruction of the parenchyma and irregular medium-large cellularity with intense and diffuse expression of CD20, CD10 and Bcl6 and a proliferative index of practically 100%, consistent with lymphoma. Burkitt stage IV. Intestinal obstruction constitutes about 15% of hospital admissions for abdominal pain, representing a significant cause of hospital mortality. Although the most common causes of small bowel obstruction are benign (adhesions, hernias), intraluminal lesions such as inflammatory bowel disease or neoplasms are well-established causes associated with this clinical picture. Lymphomas constitute 25% of cases of intestinal obstruction of neoplastic origin; among them, Burkitt lymphoma is a rare type of B-cell lymphoma characterized by rapid and aggressive cell growth, the most common initial involvement of which is located at the abdominal and extra-nodal level.
我们报告一例37岁的白种女性病例,无相关病史,因24小时进展的闭塞性病症前来急诊室。患者报告称上个月体重减轻了12千克,且上周左乳出现肿块。胸部-腹部CT扫描显示左乳有多个实性结节、肝脏转移瘤以及右髂窝处一个大小为90×60毫米的肿瘤样肿块。对乳腺病变进行活检显示为弥漫性结构模式,实质破坏,细胞大小不一呈中等至大细胞,CD20、CD10和Bcl6呈强烈弥漫性表达,增殖指数几乎为100%,符合淋巴瘤。伯基特IV期。肠梗阻约占因腹痛住院病例的15%,是医院死亡的重要原因。虽然小肠梗阻最常见的原因是良性的(粘连、疝气),但腔内病变如炎症性肠病或肿瘤也是与这种临床表现相关的既定病因。淋巴瘤占肿瘤性肠梗阻病例的25%;其中,伯基特淋巴瘤是一种罕见的B细胞淋巴瘤,其特征是细胞生长迅速且具有侵袭性,最常见的初始受累部位是腹部和结外部位。