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Primary intestinal diffuse large B-cell lymphoma forming multiple lymphomatous polyposis.

Figen Barut¹, Nilüfer Onak Kandemır, Kemal Karakaya

¹Department of Pathology, Faculty of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey. figenbarut@yahoo.com

The Turkish Journal of Gastroenterology : the Official Journal of Turkish Society of Gastroenterology

|August 2, 2011

Summary

This case report details a rare instance of diffuse large B-cell lymphoma in the small intestine, mimicking Crohn's disease. The study highlights the importance of considering this rare lymphoma in patients presenting with Crohn's-like symptoms.

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Area of Science:

Gastroenterology
Oncology
Pathology

Background:

Primary gastrointestinal lymphomas are uncommon, with multifocal and skip involvement being a rare presentation.
Diffuse large B-cell lymphoma (DLBCL) can manifest in the small intestine, posing diagnostic challenges.

Observation:

A 25-year-old male presented with symptoms suggestive of Crohn's disease, including a cobblestone-like appearance.
Macroscopic examination revealed multiple ulcerated lesions with polypoid features in the jejunoileal specimen, interspersed with healthy mucosa.

Findings:

Microscopic examination showed tumoral infiltration by pleomorphic lymphoid cells with a B-cell phenotype (vimentin, LCA, CD20, CD79a positive).
The final diagnosis was diffuse large B-cell lymphoma of the small intestine.

Implications:

This case underscores the necessity of considering rare gastrointestinal lymphomas in the differential diagnosis of Crohn's disease.
Accurate pathological and immunohistochemical analysis is crucial for distinguishing DLBCL from inflammatory bowel disease.