Peripheral Cytotoxic T Cell Lymphoma of the Appendix Presenting as Acute Appendicitis.

Negin Rahmani,Elnaz Vahidi,Hadi Mirfazaelian,Sadegh Shirian,Yahya Daneshbod

doi:10.1155/2020/8569426

Abstract

Introduction Lymphoma of the appendix is a rare cause of acute appendicitis; however, acute appendicitis is a common first manifestation of appendiceal lymphomas. Cytotoxic peripheral T cell lymphoma (PTCL) is a type of aggressive non-Hodgkin lymphoma that portends a generally poor outcome. Cytotoxic PTCL of the appendix is extremely rare with few cases reported in the literature. Case Presentation. This is the report of a 23-year-old man who had experienced lower abdominal pain for three months before presenting to the emergency department with severe right lower abdominal pain, nausea, vomiting, and anorexia since the day prior to admission. The patient was diagnosed with acute appendicitis, and the pathology report confirmed cytotoxic PTCL of the appendix. Conclusion Patients with appendiceal PTCL commonly present with signs and symptoms of acute appendicitis due to luminal obstruction by the tumor. Therefore, appendiceal tumors such as PTCL should be considered in the differential diagnosis of patients presenting as acute appendicitis. In addition, since there is no standard chemotherapy regimen for cytotoxic PTCL, this and other case reports hopefully help in providing the clinical evidence needed for establishing appropriate treatment guidelines.

Highlights

Lymphoma of the appendix is a rare cause of acute appendicitis; acute appendicitis is a common first manifestation of appendiceal lymphomas
Peripheral T cell lymphomas (PTCLs) are a group of heterogeneous lymphoproliferative disorders that originate from peripheral T cells or mature Natural Killer (NK) cells and are a subgroup of non-Hodgkin lymphomas (NHLs) [5]
PTCLs are a subdivision of T cell NHLs that include several entities such as anaplastic large cell lymphoma, nodal peripheral T cell lymphoma with TFH phenotype, and peripheral T cell lymphoma not otherwise specified (NOS)

Summary

Introduction

Lymphoma of the appendix is a rare cause of acute appendicitis; acute appendicitis is a common first manifestation of appendiceal lymphomas. Cytotoxic PTCL of the appendix is extremely rare with few cases reported in the literature. The patient was diagnosed with acute appendicitis, and the pathology report confirmed cytotoxic PTCL of the appendix. Patients with appendiceal PTCL commonly present with signs and symptoms of acute appendicitis due to luminal obstruction by the tumor. Appendiceal tumors such as PTCL should be considered in the differential diagnosis of patients presenting as acute appendicitis. Since there is no standard chemotherapy regimen for cytotoxic PTCL, this and other case reports hopefully help in providing the clinical evidence needed for establishing appropriate treatment guidelines

Background

Case Presentation

Findings

Discussion

Conclusion