A CASE OF MALIGNANT LYMPHOMA OF THE SMALL INTESTINE WITH A SPECIFIC MORPHOLOGY

Abstract

Malignant tumors of the small intestine lack in specific symptoms so that it is difficult to diagnose in an early stage. This paper reports a case of primary malignant lymphoma of the ileum which presented difficulty in differentiation from periappendicular abscess. A 20-year-old woman was occasionally febrile and had an abdominal pain scince November in 1996. In February, 1907 she noticed a mass in the right lower quadrant, and was admitted to the hospital because of right lower abdominal pain. On admission a hard tumor whose surface was smooth was palpated on the McBurney point where there were tenderness and Blumberg's sign. Anemia and inflammatory response were also noted. At first a periappendicular abscess due to acute appendicitis was suspected by clinical features and the findings of US and CT. Finally a primary tumor of the ileum, in particular malignant lymphoma was suspected and an operation was performed. Upon laparatory, a fist-sized tumor was placed in the ilececal junction and a right hemicolectomy was carried out. Histological diagnosis was diffuse and large cell type of malignant lymphoma. Postoperatively no legion was detected in the other organs. It was diagnosed as primary malignant lymphoma of the small intestine.