Diffuse large B-cell lymphoma of the colon with synchronous liver metastasis: a rare case report mimicking metastatic colorectal adenocarcinoma

BMC Surgery

Paolo Innocenti²  Luca Napolitano²  Roberto Cotellese²  Alberto D'Aulerio²  Camilla Marinelli¹  Domenico Angelucci¹  Francesco Caldaralo²  Margherita Legnini²  Rossana Percario²  Domenico Risio² 

[1] Unit of Pathology, “G. d’Annunzio” University, Chieti, Italy;Unit of General and Laparoscopic Surgery, “G. d’Annunzio” University, Via dei Vestini 31, 66100 Chieti, Italy

关键词: Primary colonic lymphoma (PCLs);    Multiple lymphomatous polyposis (MLP);    Mantle cell lymphoma (MCL);    Liver metastasis;    Diffuse large B-cell lymphoma (DLBCL);   

Others  :  1091809
DOI  :  10.1186/1471-2482-14-75

 received in 2014-06-18, accepted in 2014-09-29,  发布年份 2014

【 摘 要 】

Background

Primary colorectal lymphoma represents a rare minority among the colonic neoplasms. Early diagnosis is often difficult because of unspecific symptoms, with subsequent delays in diagnosis and management. We describe a rare case of colonic lymphoma presenting with synchronous liver metastasis.

Case presentation

A 70-year-old male with a 6-mo history of vague abdominal pain, constipation and melena was referred to our hospital. Computed tomography scan of abdomen revealed the presence of a mass along the proximal ascending colon. Colonoscopy biopsy showed external compression of the cecum with two ulcerations of mucosa, but it was not consistent for a definitive diagnosis. Because the difficulties in the preoperative pathological diagnosis, the high risk of bowel obstruction and the correlated hemorrhagic risk, the patient underwent a right hemicolectomy associated with locoregional lymphadenectomy and liver resection.

The surgically resected right colon and liver tumors were all immunohistochemically diagnosed as diffuse large B-cell lymphomas (DLBCL). The patient refused any other antineoplastic treatment; he is alive and free of disease at 3 years after initial diagnosis.

Conclusions

Primary colonic lymphomas represent a rare minority among the colonic neoplasms. Their correct pre-operative identification is crucial for the design of treatment. This case highlights the difficulty in diagnosing of primary colonic lymphoma. To our knowledge, this is the first report of a colonic lymphoma presenting with a colonic mass and a synchronous liver metastasis.

【 授权许可】

   
2014 Risio et al.; licensee BioMed Central Ltd.

【 图 表 】

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