Abdominal Lymphoma Presenting as Terminal Ileitis: A Case Report

Area of Science:

• Pediatric Oncology
• Emergency Medicine
• Surgical Pathology

Background:

• Pediatric lymphoma frequently lacks classic systemic symptoms (fever, night sweats, weight loss).
• Lymphoma can manifest with non-specific symptoms, mimicking common pediatric abdominal emergencies.
• Vague abdominal pain in children may obscure underlying oncologic diagnoses.

Observation:

• An 11-year-old male presented with 3 days of right lower quadrant pain and diarrhea, initially suspected as appendicitis.
• Imaging revealed bowel wall thickening, peritoneal thickening, and a right pleural effusion.
• Initial colonoscopy and biopsies were non-diagnostic, but worsening symptoms led to further investigation.

Findings:

• Laparoscopic biopsies confirmed Burkitt lymphoma in the omentum and terminal ileum.
• Lactate dehydrogenase (LDH) levels were mildly elevated.
• Computed tomography (CT) scans showed characteristic inflammatory and fluid changes.

Implications:

• Emergency physicians must consider pediatric lymphoma in the differential diagnosis of abdominal pain.
• Awareness of oncologic emergencies in children is vital for timely diagnosis and treatment.
• Appropriate laboratory and imaging studies are essential for identifying subtle signs of pediatric lymphoma.