A rare presentation of a 17-year-old female with primary colon lymphoma, presenting as intussusception: a case report

Primary colonic lymphomas are rare malignancies that mainly occur in men in their fifth to seventh decades, accounting for less than 1% of colorectal cancers. Most are B-cell non-Hodgkin lymphomas, with diffuse large B-cell lymphoma (DLBCL) being the most common subtype. Diagnosis is often challenging due to nonspecific symptoms, and management typically relies on systemic immunochemotherapy. Surgery retains a vital role in selected cases, particularly those with complications or localized disease. We present an interesting case of a 17-year-old girl with primary colonic DLBCL presenting with intussusception, who was treated at Ocean Road Cancer Institute in Tanzania.

A 17-year-old female of African origin experienced chronic abdominal pain and a loss of appetite for 6 months. An ileocolic intussusception was diagnosed through a CT scan and intraoperative findings, and a right hemicolectomy was performed. Histopathological examination of the resected specimen revealed DLBCL of the colon, with immunohistochemistry positive for CD20 and CD45, confirming a diagnosis of primary colorectal lymphoma. Later, the patient received systemic chemotherapy with R-CHOP for eight cycles. She is clinically stable and has been under follow-up for the past year.

Primary colonic DLBCL in adolescents is exceedingly rare. This case presents unique features such as chronic abdominal pain and anorexia, which can lead to misdiagnosis due to a broad differential. There is a need to provide knowledge of primary colon lymphoma to ensure early diagnosis and favorable outcomes.