Rumney Sean, Rajesh Aashish, Brigmon Erika
General Surgery, University of Texas Health Science Center at San Antonio, San Antonio, USA.
Surgery, University of Texas Health Science Center at San Antonio, San Antonio, USA.
Cureus. 2023 Apr 9;15(4):e37341. doi: 10.7759/cureus.37341. eCollection 2023 Apr.
Diffuse large B-cell lymphoma (DLBCL) is the most common form of non-Hodgkin's lymphoma and can rarely present as a primary gastrointestinal malignancy. Primary gastrointestinal lymphoma (PGIL) is associated with a significant risk of perforation and peritonitis, with high rates of mortality. Here we describe a case of a newly diagnosed PGIL in a previously healthy 22-year-old male presenting for new-onset abdominal pain with diarrhea. Early hospital course was characterized by peritonitis and severe septic shock. Despite multiple surgical interventions and resuscitative efforts, the patient's condition continued to deteriorate until cardiac arrest and death on hospital day five. A diagnosis of DLBCL of the terminal ileum and cecum was made by pathology post-mortem. The prognosis for these patients can be improved through early intervention with chemotherapy regimens and surgical resection of the malignant tissue. This report highlights DLBCL as a rare cause of gastrointestinal perforation that can culminate in precipitous multiorgan failure and death.
弥漫性大B细胞淋巴瘤（DLBCL）是非霍奇金淋巴瘤最常见的形式，很少以原发性胃肠道恶性肿瘤的形式出现。原发性胃肠道淋巴瘤（PGIL）与穿孔和腹膜炎的显著风险相关，死亡率很高。在此，我们描述一例新诊断的PGIL病例，患者为一名22岁此前健康的男性，因新发腹痛伴腹泻就诊。早期住院过程以腹膜炎和严重感染性休克为特征。尽管进行了多次手术干预和复苏努力，但患者的病情持续恶化，直至在住院第5天心脏骤停并死亡。尸检病理诊断为回肠末端和盲肠的DLBCL。通过早期采用化疗方案进行干预以及手术切除恶性组织，这些患者的预后可以得到改善。本报告强调DLBCL是胃肠道穿孔的罕见原因，可导致急剧的多器官功能衰竭和死亡。
