Jejunal B-Cell Non-Hodgkin Lymphoma Presenting with a Long Stenosing Lesion in an Adolescent: A Case Report

Jejunal involvement by pediatric B-cell non-Hodgkin lymphoma (NHL) can be difficult to diagnose when the lesion lies beyond conventional endoscopic reach.

A previously healthy 15-year-old boy presented with 2 weeks of postprandial vomiting, periumbilical pain, weight loss, peripheral lymphadenopathy, and a palpable abdominal mass. CT identified a large segment of jejunal thickening. Enteroscopy showed approximately 12 cm of ulcerated, friable stenosis with contact bleeding; the endoscope could traverse the affected segment. Biopsies demonstrated an atypical lymphoid infiltrate, and immunohistochemistry supported CD20-positive B-cell NHL without a definitive subtype. Persistent vomiting led to surgical exploration, which showed extensive abdominal disease considered unresectable. A palliative gastrojejunostomy was performed. Further molecular and formal staging investigations were not completed, and the patient died before planned chemotherapy.

This case highlights the complementary diagnostic roles of CT and enteroscopy in jejunal lymphoma and the need to coordinate gastrointestinal palliation with prompt pathological and oncologic assessment. The available findings do not establish a specific lymphoma subtype or verifiable pediatric stage.