Chua Nicole Allyson, Sollano Jose
Section of Gastroenterology, Cardinal Santos Medical Center, San Juan City, Philippines
Section of Gastroenterology, Cardinal Santos Medical Center, San Juan City, Philippines.
BMJ Case Rep. 2024 Dec 11;17(12):e259507. doi: 10.1136/bcr-2023-259507.
Primary gastrointestinal tract lymphoma (PGIL) is a rare form of presentation of gastrointestinal tract (GI) lymphomas. Inflammatory bowel disease (IBD) and the use of thiopurines are known risk factors for its appearance. We report a male patient in his early 70s treated only with mesalamine for ulcerative colitis (UC) for the past 6 years. He was admitted due to COVID-19 and anaemia secondary to massive haematochezia. The patient underwent total colectomy with end ileostomy, with intraoperative proctoscopy. Tissue biopsy demonstrated typical features of UC; however, atypical lymphoid proliferation of the regional lymph nodes with histological and immunochemical staining results was suggestive of classic Hodgkin lymphoma, nodular sclerosis subtype. The patient was treated with adriamycin, vinblastine and dacarbazine chemotherapy initially successful after 1 session but later opted for palliative care. Due to its rarity, lymphoid neoplasms occurring in the context of IBD are poorly known.
原发性胃肠道淋巴瘤(PGIL)是胃肠道(GI)淋巴瘤的一种罕见表现形式。炎症性肠病(IBD)和硫嘌呤的使用是其出现的已知危险因素。我们报告一名70岁出头的男性患者,在过去6年中仅接受美沙拉嗪治疗溃疡性结肠炎(UC)。他因COVID-19和大量便血继发贫血入院。患者接受了全结肠切除术加末端回肠造口术,并进行了术中直肠镜检查。组织活检显示为UC的典型特征;然而,区域淋巴结的非典型淋巴样增殖,结合组织学和免疫化学染色结果,提示为经典型霍奇金淋巴瘤,结节硬化亚型。患者最初接受阿霉素、长春花碱和达卡巴嗪化疗,1个疗程后最初取得成功,但后来选择了姑息治疗。由于其罕见性,IBD背景下发生的淋巴样肿瘤鲜为人知。