| Autor: |
García Calonge M; Gastroenterology, Hospital Universitario Central de Asturias, Spain., Fernández Cadenas F; Gastroenterology, Hospital Universitario Central de Asturias., González Sánchez H; Gastroenterology, Hospital Universitario Central de Asturias, España., Muíño-Domínguez D; Gastroenterology, Hospital Universitario Central de Asturias, España., Morais Bras L; Hematology, Hospital Universitario Central de Asturias., García Ramos M; Radiology, Hospital Universitario Central de Asturias., Sanz Álvarez L; General Surgery, Hospital Universitario Central de Asturias., Riestra S; Gastroenterology and Hepatology, Hospital Universitario Central de Asturias. |
| Jazyk: |
angličtina |
| Zdroj: |
Revista espanola de enfermedades digestivas [Rev Esp Enferm Dig] 2024 Sep; Vol. 116 (9), pp. 502-504. |
| DOI: |
10.17235/reed.2023.10004/2023 |
| Abstrakt: |
An increased risk of hematologic malignancies secondary to long-term immunomodulators and biologics has been described in patients with inflammatory bowel disease1. Here, we present a case of jejunal stricture after chemotherapy treatment in a patient with ileal Crohn´s disease (CD) and jejunal lymphoma. The patient was a 32-year-old male with ileal CD in remission presenting with abdominal pain and distension. Abdominal computed tomography (CT) showed a poorly defined mass in the proximal jejunum, and positron emission tomography (PET) - CT showed hypermetabolic activity at that level. An upper endoscopy evidenced an indurated, friable circumferential mass causing a significant reduction of the intestinal lumen. Histological and cytometry findings led to a diagnosis of large B cell lymphoma, for which the patient received standard treatment (R-CHOP and IPI), achieving complete response. Eight months later, the patient reported abdominal pain and distention. Abdominal CT showed a thickening of a short segment of the proximal jejunum. An upper endoscopy showed a punctiform stenosis, while multiple biopsies showed neither histological recurrence of lymphoma nor signs of IBD. The patient was diagnosed with a post-chemotherapy stricture and underwent progressive endoscopic balloon dilatation. He finally was scheduled for laparoscopic small bowel resection. An histological analysis of the surgical piece revealed a granulomatous reaction with multinucleated foreign body-like giant cells, without evidence of malignancy (recurrence of lymphoma) nor inflammatory infiltrate suggesting CD. The patient currently remains asymptomatic with no new episodes of abdominal pain. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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