School of Medicine, University of California San Francisco, San Francisco, California, USA
Department of Pathology, University of California San Francisco, San Francisco, California, USA.
BMJ Case Rep. 2023 Aug 22;16(8):e256166. doi: 10.1136/bcr-2023-256166.
Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin's lymphoma. Extranodal involvement, including the gastrointestinal tract, occurs frequently. However, colorectal involvement is extremely rare. We present a case of a man in his 20s with prior renal transplantation on immunosuppression for 10 years who developed symptoms of gas and bloating associated with unintentional weight loss. Colonoscopy revealed a large fungating mass at the ileocaecal valve, and a biopsy of this lesion confirmed stage IV DLBCL. Endoscopy should be considered for early workup of vague gastrointestinal symptoms, even in younger patients, if they have been on long-standing immunosuppression.
弥漫性大 B 细胞淋巴瘤（DLBCL）是最常见的非霍奇金淋巴瘤类型。结外累及，包括胃肠道，经常发生。然而，结直肠受累极为罕见。我们报告了一例 20 多岁的男性，他在免疫抑制治疗 10 年后接受了肾移植，出现了气胀和体重意外减轻的症状。结肠镜检查显示回盲瓣处有一个大的蕈样肿块，该病变的活检证实为 IV 期 DLBCL。如果年轻患者长期接受免疫抑制治疗，即使出现不明确的胃肠道症状，也应考虑进行内镜检查以进行早期检查。
