Multiple intestinal perforations due to primary mediastinal B-cell lymphoma: A case with an infrequent extra-nodal presentation
| Autor: | René M. Palacios Huatuco, Diana A. Pantoja Pachajoa, Alejandro M. Doniquian, Agustín E. Pinsak, Mario L. Salvano, Facundo Mandojana |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Perforation (oil well) Case Report 03 medical and health sciences 0302 clinical medicine Laparotomy medicine Chemotherapy Non-Hodgkin lymphoma Superior vena cava syndrome business.industry Stomach Bowel perforation medicine.disease Lymphoma medicine.anatomical_structure Large B-cell diffuse lymphoma 030220 oncology & carcinogenesis Extra-nodal extension 030211 gastroenterology & hepatology Surgery Primary mediastinal B-cell lymphoma Radiology medicine.symptom Pancreas business Complication |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Highlights • Primary mediastinal large B-cell lymphoma (PMBCL) is confined to the mediastinum or contiguous nodal areas in most cases. • PMBCL is characterized by a rapidly growing mediastinal mass, frequently accompanied by local invasiveness. • Gastrointestinal involvement of PMBCL may cause serious complications such as intestinal perforation. • PET-CT increases the sensitivity of staging by detecting unusual sites of disease localization. Introduction Primary mediastinal B-cell lymphoma (PMBCL) is an uncommon subtype of non-Hodgkin lymphoma (2–3%), predominantly occurring in female young adults. Extrathoracic involvement is found in 10–20%. It can affect the kidneys, pancreas, stomach, adrenal glands, liver, and infrequently the central nervous system (6–9%). There is currently only one reported case of ileum dissemination with a single perforation. Presentation of case A 51-year-old woman with a history of PMBCL, hospitalized by a superior vena cava syndrome. PET-CT showed numerous lesions in the small intestine, pancreas, adrenal glands, and left kidney. During chemotherapy she presented abdominal symptoms, requiring an emergency laparotomy. On examination, six perforation sites were found in the small intestine. The pathology report revealed lesions compatible with PMBCL spread. Discussion There are few case series with reports of dissemination in the gastrointestinal tract, with the main location in the stomach. Knowing the visceral location of the PMBCL would allow us to plan a strict follow-up during the first phases of chemotherapy treatment, as well as the early diagnosis of unexpected complications, such as intestinal perforation. Conclusion The PMBCL is a rare entity. Visceral involvement should be suspected in these patients since intestinal perforation represents a complication with high morbidity and mortality. This is the first case reported with numerous intestinal locations and multiple post-chemotherapy perforations. |
| Databáze: | OpenAIRE |
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