Malignant Lymphoma of the Ileum Treated by Laparoscopically Assisted Bowel Resection : A Case Report

Abstract

Primary malignant lymphoma of the small intestine is uncommon. We herein present a case of malignant lymphoma of the ileum, which was treated by laparoscopically assisted surgery. A 60-yearold male with lower abdominal pain and vomiting was admitted to our hospital. A standing abdominal X-ray showed niveau formation. Computed tomography demonstrated circumferential wall thickening in the terminal ileum. Laparoscopically assisted surgery was performed under a diagnosis of tumor of the ileum. Under laparoscopic exploration, tumor of the ileum was detected. Partial resection of the ileum and dissection of lymph nodes were performed extracorporeally. Histological findings demonstrated diffuse large atypical lymphocytes with vesicle-like chromatin and clear nucleolus. Immunologically, CD20 and CD79a were positive. These findings were compatible with those of diffuse large B-cell lymphoma. Paraintestinal lymph nodes were also involved. The postoperative course was uneventful. Neither gallium scintigraphy nor FDG-PET showed any scintillation. The patient was given R-CHOP therapy and is currently doing well with no sign of recurrence. In conclusion, we propose that laparoscopic surgery for malignant lymphoma of the small intestine is a feasible and promising therapeutic option, especially in a case demonstrating bowel obstruction, because this procedure is thought to be minimally invasive,allows quick postoperative recovery and shortened hospital stay could be expected.