Primary Gastrointestinal Diffuse Large B-cell Lymphoma Presenting as Ileal Perforation

Area of Science:

• Oncology
• Gastroenterology
• Pathology

Background:

• Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin's lymphoma.
• Primary gastrointestinal lymphoma (PGIL) is a rare presentation of DLBCL.
• PGIL carries a significant risk of perforation, peritonitis, and mortality.

Observation:

• A previously healthy 22-year-old male presented with abdominal pain and diarrhea.
• The patient developed peritonitis and septic shock, requiring intensive medical and surgical interventions.
• Despite extensive efforts, the patient experienced multiorgan failure and died on hospital day five.

Findings:

• Post-mortem pathology confirmed DLBCL of the terminal ileum and cecum.
• This case illustrates DLBCL as a rare cause of gastrointestinal perforation.
• The rapid deterioration highlights the aggressive nature of this presentation.

Implications:

• Early diagnosis and intervention, including chemotherapy and surgical resection, can improve prognosis for PGIL.
• This case underscores the importance of considering DLBCL in young patients with gastrointestinal emergencies.
• Raising awareness of rare gastrointestinal malignancies like DLBCL is vital for timely management.