[MALT lymphoma of the ileum as the cause of an enterocolic invagination].

HISTORY AND FINDINGS

A 44-year-old woman who had moved to Germany from Kazakhstan 2 years previously developed right upper abdominal pain. A cylindrical mass was palpable in the area. There were strong intestinal sounds.

INVESTIGATIONS

There was an iron-deficiency anaemia (haemoglobin 6.3 g/dl, serum iron 4 micrograms/dl) and occult blood was found in the stool. Coloscopy revealed a lumpy mass external to the transverse colon but fixed to it, partially obstructing the lumen. However, on contrast infusion the mass could be displaced in to the caecum, suggesting enterocolic invagination.

TREATMENT AND COURSE

At operation the cause of the investigation was found to be a large jagged tumour of the terminal ileum. A right hemicolectomy and excision of the terminal ileum were performed. Histologically the tumour was a centroblastic non-Hodgkin lymphoma of the MALT type (mucosa-associated lymphatic tissue).