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Composite lymphoma in a patient with ulcerative colitis: a case report
Farzaneh Ashrafi1, Farid Kowsari2, Ali Darakhshandeh3
1Hematology &Oncology section, Department of Internal Medicine, School of Medicine, Isfahan University of Medical sciences, Isfahan, Iran.
Summary
A rare composite lymphoma, combining diffuse large B-cell lymphoma and nodular sclerosing Hodgkin lymphoma, was diagnosed in a patient with ulcerative colitis. This case highlights the complex presentation of lymphomas in patients with inflammatory bowel disease.
Area of Science:
- Oncology
- Gastroenterology
- Pathology
Background:
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
- Patients with UC have an increased risk of developing certain cancers, including lymphoma.
- Composite lymphomas are rare neoplasms comprising two or more distinct lymphoma subtypes.
Purpose of the Study:
- To report a rare case of composite lymphoma in a patient with ulcerative colitis.
- To describe the clinical presentation, diagnostic findings, and treatment of this complex condition.
- To discuss the potential association between ulcerative colitis and the development of composite lymphoma.
Main Methods:
- A 45-year-old female patient with a history of ulcerative colitis presented with constitutional symptoms and cytopenias.
- Diagnostic workup included physical examination, laboratory tests, and computed tomography (CT) scan.
- Surgical intervention involved splenectomy and excisional lymph node biopsy for histopathological diagnosis.
Main Results:
- The patient presented with malaise, weakness, fatigue, splenomegaly, and pancytopenia.
- CT scan revealed splenomegaly and para-aortic lymphadenopathy.
- Histopathological examination confirmed a composite lymphoma composed of diffuse large B-cell lymphoma and nodular sclerosing Hodgkin lymphoma.
Conclusions:
- Composite lymphoma is a rare but serious complication that can occur in patients with ulcerative colitis.
- Early diagnosis and appropriate management are crucial for improving patient outcomes.
- Further research is needed to elucidate the underlying mechanisms linking inflammatory bowel disease and the development of composite lymphomas.
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