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Published on: March 30, 2018
A Syrian Child with Intussusception Caused by a Diffuse Large B-Cell Lymphoma
Rahaf Toutounji1, Ahmad Ghazal2, Aghyad Kudra Danial2
1Department of Dermatology, Aleppo University Hospital, Aleppo, Syria.
Insights
Intussusception in older children can be subtle, often caused by lymphoma. Early detection of a lead point mass is crucial for timely diagnosis and treatment of this rare condition.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Oncology
Background:
- Intussusception, the telescoping of one bowel segment into another, is common in infants but rare in older children.
- In older children, intussusception often presents with nonspecific symptoms, complicating diagnosis.
- Malignancy as a lead point for intussusception is uncommon but must be considered in this age group.
Observation:
- An 11-year-old boy presented with acute abdominal pain and weight loss, symptoms suggestive of intussusception.
- Imaging revealed ileocolic intussusception with an obstructing mass.
- The mass was surgically resected along with affected bowel and lymph nodes.
Findings:
- Histological examination confirmed diffuse large B-cell Non-Hodgkin's lymphoma as the cause of intussusception.
- This specific lymphoma subtype is uncommon in the Middle East.
- The patient's presentation mimicked more common pediatric intussusception cases.
Implications:
- This case highlights the importance of investigating lead points in older children with intussusception.
- It underscores the need to consider malignancy, even rare types, in the differential diagnosis.
- Prompt surgical intervention and histological analysis are vital for accurate diagnosis and management of pediatric intussusception.
Abstract:
Intussusception is the invagination of a segment of the bowel into an adjacent segment. Here, we describe a middle-eastern case of an 11-year-old boy who presented to our institution with an intussusception caused by lymphoma but with nonspecific symptoms such as acute abdominal pain and a history of weight loss. His abdominal ultrasound and computed tomography (CT) showed ileocolic intussusception with a mass leading it. We resected the mass with the affected bowel and related lymph nodes, and the histological examination showed features of diffuse large B-cell Non-Hodgkin's lymphoma (an uncommon histologic type in the Middle East). Known as intussusception, this urgent condition could distress infants and young children. However, in older children, the presentation is subtler. So, a lead point should be observed and the chance of malignancy should be kept in mind.
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