Enteric diffuse large B-cell lymphoma: case report

Abstract

Introduction: Lymphoma is a malignant neoplasm originating from abnormal proliferation of lymphocytes that can affect lymph nodes or other organs. This entity represents about 5% of oncological diseases and can be classified as Hodgkin lymphoma and non-Hodgkin lymphoma. Primary gastrointestinal lymphoma is rare, accounting for 10% to 20% of extranodal lymphoma cases. Its main origin is in B-cells, with diffuse large B-cell lymphoma (DLBCL) being the most frequent subtype. Affected individuals are typically male and over 55 years old.

Case report: A 57-year-old woman sought medical attention due to symptoms of anorexia, abdominal pain, distension, constipation, diarrhea, and vomiting. After evaluation, acute abdomen was suspected, and an abdominal tomography was requested, which revealed an expansive lesion in the ileal loop associated with intestinal sub occlusion. The patient underwent exploratory laparotomy with enterectomy. Anatomopathological and immunohistochemical analysis identified the lesion as primary enteric DLBCL. Remission of the disease was achieved after a chemotherapy treatment consisting of six cycles of R-CHOP.

Discussion: Primary cancers of the small intestine are rare, accounting for less than 2% of all gastrointestinal neoplasms. The presentation of lymphomas in this region can be nonspecific. Therefore, imaging exams are important for diagnosis, but histopathological analysis of the lesion is necessary for confirmation. Treatment typically involves chemotherapy and rituximab, along with surgical resection of the tumor. Prognosis depends on the histological subtype, with worse outcomes observed in high-grade lymphomas such as DLBCL.

Conclusion: Primary enteric lymphoma is an uncommon and aggressive condition with nonspecific symptoms. Reporting pathological entities like this is important to inform healthcare professionals about the topic and contribute to the dissemination of knowledge in this field.