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  • Title: Diffuse large B-cell lymphoma associated ileocecal intussusception in adulthood.
    Author: Rajabto W, Priantono D, Harahap AS, Handjari DR.
    Journal: Klin Onkol; 2022; 35(3):236-239. PubMed ID: 35760577.
    Abstract:
    BACKGROUND: Intussusception in adults is considered a rare condition, accounting for 5% of all cases of intussusceptions and approx. 1-5% of bowel obstruction. Almost half intussusceptions of the bowel are associated with malignant disease; thus, we should also treat the underlying malignancy. CASE DESCRIPTION: A 52-year-old male presented with colicky right lower abdominal pain for a 6-month period. He had a weight loss of 20kg within 6 months. Physical examination revealed a tender right lower abdominal mass. Colonoscopy showed a mass that filled the ileocecal. The digestive surgeon performed laparoscopic right hemicolectomy with end-to-end anastomosis. Histopathology examination showed diffuse proliferation of large tumor cells with centroblastic-like features prominently in submucosal area, with normal epithelial mucosa. The immunohistochemistry result concluded the final dia-gnosis of diffuse large B-cell lymphoma. RCHOP chemotherapy regimens were administered every 3 weeks for 6 cycles. The response was complete remission. DISCUSSION: Intussusception was preoperatively dia-gnosed by multi-slice spiral CT scans with the characteristic target or sausage sign, edematous bowel wall and mesentery in the lumen. After surgery, approximately 90% of adult intussusception cases have a demonstrable etiology. Malignant lymphoma, especially diffuse large B-cell lymphoma, of the ileocecal is one cause of the adult intussusception. CONCLUSION: Adult bowel intussusception is a rare clinical entity. Abdominal CT is considered as the most sensitive imaging modality in the dia-gnosis of intussusception. Diffuse large B-cell lymphoma is the most common cause of ileocecal intussusception.
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