Takiguchi N, Sarashina H, Saitoh N, Nunomura M, Kouda K, Ozaki K, Nakajima N, Fujihira T, Mikata A
First Department of Surgery, Chiba University School of Medicine, Japan.
J Gastroenterol. 1996 Aug;31(4):603-6. doi: 10.1007/BF02355066.
A rare adult case of intussusception caused by malignant lymphoma of the cecum with intramural metastasis is reported. The patient was a 24-year-old man. Ileocolic intussusception was diagnosed by characteristic findings on abdominal computed tomography. Endoscopic examination revealed a massive protuberant tumor, 3 cm in diameter, and a semipedunculated polyp, 1 cm in diameter, in the cecum, which had caused the ileocolic intussusception. Endoscopic biopsy specimens failed to yield a definitive diagnosis histologically, but right hemicolectomy with lymph node dissection was performed. On histologic examination of the surgical specimens, both the tumor and the polyp were diagnosed as diffuse lymphoma of medium-sized cell type, and no lymph node involvement was found. The patient responded well to surgical and chemotherapeutic treatment, and has had no recurrence of malignant lymphoma in the 2 years since the surgical treatment. This was a very rare case of an intussusception in an adult patient due to malignant lymphoma in the cecum with intramural metastasis and without lymph node involvement.
报告了一例罕见的成人肠套叠病例,由盲肠恶性淋巴瘤伴壁内转移引起。患者为一名24岁男性。通过腹部计算机断层扫描的特征性表现诊断为回结肠型肠套叠。内镜检查发现盲肠内有一个直径3厘米的巨大突出肿瘤和一个直径1厘米的半蒂息肉,这导致了回结肠型肠套叠。内镜活检标本在组织学上未能得出明确诊断,但进行了右半结肠切除术及淋巴结清扫术。对手术标本进行组织学检查时,肿瘤和息肉均被诊断为中等细胞型弥漫性淋巴瘤,且未发现淋巴结受累。患者对手术和化疗治疗反应良好,自手术治疗以来的2年中恶性淋巴瘤未复发。这是一例非常罕见的成人患者因盲肠恶性淋巴瘤伴壁内转移且无淋巴结受累而导致的肠套叠病例。