Patchy Left-Sided Colitis: Primary Eosinophilic Colitis or Paraneoplastic Syndrome?

Abstract

A 46-year-old man, affected by low-grade marginal zone B-cell lymphoma of splenic origin, presented with persistent abdominal pain, diarrhea, and hematochezia. The patient was not taking any medication. Blood analyses revealed augmented eosinophilic count (7.3%). Serological tests and stool tests were negative for parasitic/nonparasitic infections. The screenings for autoimmune disorders, allergies, and celiac disease were also negative. The colonoscopy showed a left-sided, patchy colitis, with zones of erythema, edema, and erosions covered with fibrin, alternated to macroscopically normal areas (Figure A and B).