Abstract
Literature in the IBD population has reported increased risks for malignancy including lymphoproliferative disorders associated with biologic and thiopurine medications. A 55 year old male with a history of Crohn's disease presented with multiple symptoms of mid-abdominal pain, nausea, vomiting, constipation, and lack of flatus for three days. He had previous intestinal resections and intermittent therapy including systemic steroids, infliximab, azathioprine, and 5-ASA. The patient was found to have a small bowel obstruction which required surgical intervention and a nonpatent segment of an ileocolonic anastomosis was resected. Histological analysis of the resected anastomotic segment revealed positivity for PAX5, CD30, BCL-2, OCT-2, MUM1 for large cells. Neoplastic cells showed altered B-cell phenotype and decreased expression of PAX5, CD20, CD79a and BOB.1 consistent with Reed Sternberg cells. In-situ hybridization was positive for EBER confirming Epstein-Barr virus. The patient was diagnosed with ileocolonic anastomosis EBV positive classical Hodgkin lymphoma in Crohn's disease.Figure 1Figure 2Figure 3
Published Version
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