Abstract

A 76-year-old man presented with a two-month history of slight fever and lower abdominal pain. Colonoscopy showed slightly reddish mucosa with many white spots at the rectum. Biopsy specimens from the rectum showed no malignancy. Colonoscopy was performed again two months later, and revealed a circumferential ulcer and fistula tract at the rectum. The fistula communicated with the small bowel. Biopsy specimens from the fistula showed diffuse large B-cell lymphoma. Ileorectal resection and Hartmann’s operation were performed. Histopathological examination demonstrated diffuse large B-cell lymphoma of the ileum invading the rectum. We confirmed the presence of slightly reddish mucosa with many white spots at the rectum prior to the formation of an ileorectal fistula.

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