No abstract

Plasmablastic lymphoma (PBL) is an uncommon human immunodeficiency virus (HIV)associated lymphoma, with a predilection to develop in the oral cavity. It usually has a plasmablastic morphology with weak or no expression of B cell-associated markers. Among non-HIV patients, it tends to occur in the gastrointestinal (GI) tract, lymph nodes, and skin.We experience a 74-year-old male who presented with abdominal discomfort, altered bowel habit, loss of weight, and loss of appetite with a palpable abdominal mass. Upper endoscopy revealed multiple dish-like and raised nodular mass with a central ulcer in the stomach and duodenum. The histology was consistent with high-grade lymphoma of the plasmablastic type.The immunohistochemistry was positive for plasma cells marker of CD38 and CD138, but negative for the lymphocytic marker of CD45, as well as mature T and B cell marker of CD3 and CD20. Unfortunately, the patient succumbed due to sepsis without completion of his investigations and treatments.

Background Intestinal obstruction is a common surgical emergency that is presented to the hospital with various aetiologies. Among all, mesenteric lipoma is one of the uncommon extraluminal causes of intestinal obstruction. In such conditions, bowel volvulus, compression or even adhesion are the underlying pathologies. Case presentation We report a 69-year-old gentleman who presented with a triad of intestinal obstruction which required exploratory laparotomy. Preoperative computed tomography revealed multiple coalescing lobulated hypoattenuating lesions encircling part of a small bowel forming transitional zone. These lesions are comparatively more hypoattenuating in comparison with the surrounding mesenteric fat. Intraoperatively, a giant ileal mesenteric lipoma was identified causing compression and folding to the adjacent small bowel, leading to proximal bowel dilatation. Excision of the lipoma with a few mesenteric lymphadenectomy was done, revealing a benign mesenteric lipoma and reactive lymph nodes. Despite ileus, he made a good postoperative recovery and was discharged well. Conclusions Patients with recurrent abdominal pain must have a thorough endoscopic and imaging assessment. Besides common or malignant aetiology, rarities should be considered and actively sought. Mesenteric lipoma is a relatively indolent tumour for which early detection can alter clinical presentation.