Mesenteric small cell lymphocytic lymphoma presenting as acute intestinal obstruction: A rare case scenario

Anurag Singh, Puneet Sharma, Ayushya Gupta, Nancy Thakur
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Abstract

Small-cell lymphocytic lymphoma is a rare type of B-cell non-Hodgkin lymphoma. It is known as one of the indolent lymphomas. Moreover, sigmoid volvulus as an initial presentation is extremely uncommon. We encountered a unique case of mesenteric small cell lymphocytic lymphoma that presented with sigmoid volvulus as the initial clinical presentation. A 55-year-old male presented with 7-day history of abdominal pain, abdominal distension for 6 days, and non-passage of stool and flatus with recurrent vomiting for 3 days. Abdominopelvic computed tomography revealed a distended small bowel with volvulus of sigmoid colon with twisting of its mesentery with inter-ileal as well as free peritoneal collections of fluid. A manual untwisting counterclockwise of the volvulus followed by resection and anastomosis at a point where the bowel has apparent normal thickness and color along with excisional biopsy of the enlarged lymph node. Histopathology confirmed the diagnosis of small-cell lymphocytic lymphoma. Mesenteric lymphomas are less likely to present with sigmoid volvulus as the initial clinical presentation due to their extraluminal location and also they are indolent in course. Early diagnosis and its management reduce morbidity and mortality.
肠系膜小细胞淋巴细胞淋巴瘤表现为急性肠梗阻:罕见病例
小细胞淋巴细胞淋巴瘤是一种罕见的 B 细胞非霍奇金淋巴瘤。它被认为是一种不活跃的淋巴瘤。此外,以乙状结肠肿胀为首发症状的病例也极为罕见。我们遇到了一例独特的肠系膜小细胞淋巴细胞淋巴瘤病例,其最初临床表现为乙状结肠扩张。一名 55 岁的男性患者因腹痛 7 天、腹胀 6 天、大便和胃肠胀气无法排出且反复呕吐 3 天而就诊。腹部盆腔计算机断层扫描显示,小肠胀大,乙状结肠发生肿胀,肠系膜扭曲,肠间和游离腹腔积液。在肠管厚度和颜色明显正常的情况下,人工逆时针切开肠管,然后进行切除和吻合,并对肿大的淋巴结进行切除活检。组织病理学确诊为小细胞淋巴细胞淋巴瘤。肠系膜淋巴瘤由于位于肠腔外,以乙状结肠下腹部肿物为最初临床表现的可能性较小,而且病程迁延。早期诊断和治疗可降低发病率和死亡率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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