Sánchez-Villegas María Guadalupe, Zúñiga-Mejía Daniel, Recinos-Carrera Elio Germán, Montero-Flores Gerardo Gabriel, Nuñez-Venzor Alejandra
Faculty of Medicine, National Autonomous University of Mexico (UNAM), Escolar 411A, Copilco Universidad, Coyoacán, 04360 Mexico City, Mexico.
Department of General and Endoscopic Surgery, Dr. Manuel Gea González General Hospital, Calzada de Tlalpan 4800, Belisario Domínguez Section XVI, Tlalpan, 14080 Mexico City, Mexico.
J Surg Case Rep. 2025 Mar 26;2025(3):rjaf147. doi: 10.1093/jscr/rjaf147. eCollection 2025 Mar.
The gastrointestinal tract is the most frequent extranodal site of non-Hodgkin lymphoma (NHL), accounting for up to 40% of cases. However, appendiceal lymphoma is exceptionally rare, with peritoneal involvement being even rarer. Appendiceal lymphoma often mimics acute appendicitis (AA), although it is an uncommon initial manifestation of intestinal NHL, complicating diagnosis. We report a 29-year-old male with human immunodeficiency virus (HIV) who presented with AA. An open appendectomy was planned; however, intraoperative findings- including cecal induration, ascites, peritoneal thickening, and macronodular lesions on the peritoneum and intestines-led to abandonment of the procedure. Postoperative evaluation excluded peritoneal tuberculosis (PTB), while computed tomography (CT) suggested peritoneal carcinomatosis (PC). Histopathological analysis of a parietal peritoneum specimen provided the definitive diagnosis of NHL. Appendiceal NHL should be considered in HIV-positive patients with AA. Routine histopathological evaluation and surgical intervention are essential for accurate diagnosis and effective management.
胃肠道是非霍奇金淋巴瘤（NHL）最常见的结外部位，占病例的40%。然而，阑尾淋巴瘤极为罕见，腹膜受累更为罕见。阑尾淋巴瘤常酷似急性阑尾炎（AA），尽管它是肠道NHL的一种不常见的初始表现，这使得诊断变得复杂。我们报告一名29岁的人类免疫缺陷病毒（HIV）感染男性，其表现为急性阑尾炎。计划进行开放性阑尾切除术；然而，术中发现——包括盲肠硬结、腹水、腹膜增厚以及腹膜和肠道上的大结节性病变——导致手术放弃。术后评估排除了腹膜结核（PTB），而计算机断层扫描（CT）提示腹膜癌病（PC）。壁层腹膜标本的组织病理学分析提供了NHL的明确诊断。对于患有急性阑尾炎的HIV阳性患者，应考虑阑尾NHL。常规组织病理学评估和手术干预对于准确诊断和有效管理至关重要。
