A Case of Small Bowel Diffuse Large B-cell Lymphoma Mimicking Crohn's Disease

Koo, Tae Hyoung; Choi, Won Jong; Han, Seung Hee; Kim, Su Young; Lee, Jong-Hun

doi:10.4166/kjg.2015.65.4.241

Cited by 4 publications

(2 citation statements)

References 18 publications

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“…The presentation of small bowel lymphoma has historically caused delays in its diagnosis due to its presentation sometimes sharing many features, including symptomatology, roentgenograms, gross and microscopic findings with IBD, leading to misdiagnoses [8][9][10][11][12][13][14]. As seen in Table 2, there have been six previously reported cases of small bowel lymphomas initially misdiagnosed as CD.…”

Section: Discussionmentioning

confidence: 99%

Rare Jejunal Large B-cell Lymphoma Mimicking a Crohn’s Disease Without Terminal Ileum Involvement

Kaye¹,

Choi²,

Wong³

et al. 2022

Cureus

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This case describes a 49-year-old man who presented with a several-month history of melena, and unintentional weight loss. Prior esophagogastroduodenoscopy and colonoscopy were unrevealing. Further evaluation with capsule endoscopy showed patchy erythematous mucosa in the jejunum creating suspicion for Crohn's Disease. Subsequent push enteroscopy found nodular and congested patchy mucosa of jejunum, and stigmata of bleeding in the proximal and mid-jejunum. Repeat colonoscopy showed a diffuse area of erythematous mucosa in the recto-sigmoid colon, and moderately congested mucosa in the ascending colon, but a normal terminal ileum. A small bowel biopsy eventually revealed large B-cell lymphoma. This is one of the first seven reported cases of small bowel lymphoma mimicking Crohn's Disease and the first to not have any ileal involvement.

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Section: Discussionmentioning

confidence: 99%

Rare Jejunal Large B-cell Lymphoma Mimicking a Crohn’s Disease Without Terminal Ileum Involvement

Kaye¹,

Choi²,

Wong³

et al. 2022

Cureus

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“…Apart from Crohn’s disease (CD), terminal ileitis is attributed to various different causes [ 7 ]. It may be related to drugs, in particular nonsteroidal anti-inflammatory drugs (NSAID) [ 8 - 10 ], intestinal infections [ 11 - 14 ], vascular disorders [ 15 , 16 ], and neoplasms [ 17 - 19 ], or may rarely occur in the context of spondyloarthropathies [ 20 ] and infiltrative diseases [ 21 , 22 ]. The term “nonspecific terminal ileitis” is used for cases in which a definite cause of isolated terminal ileitis cannot be identified and ileal biopsies do not lead to a specific diagnosis [ 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

Isolated nonspecific terminal ileitis: prevalence, clinical evolution and correlation with metachronous diagnosis of Crohn’s disease: a retrospective study and review of the literature

Koureta

2024

aog

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Background The existing literature does not provide adequate guidance on the diagnosis and management of patients with nonspecific terminal ileitis, while data regarding the percentage of patients who ultimately develop Crohn’s disease (CD) are scarce. We evaluated the prevalence and natural course of nonspecific terminal ileitis in patients who underwent colonoscopy during a 11-year period. Methods All patients with endoscopic findings of terminal ileitis and nonspecific histological findings were included. Exclusion criteria were a clinical history of CD or any other disease that can cause terminal ileitis, or a recent history of using drugs implicated in lesions of the terminal ileum. Results From 5353 colonoscopies, 92 patients with nonspecific terminal ileitis were identified (prevalence: 1.7%). Among these patients, 56 (61%) had available follow up for ≥6 months after the initial endoscopy. Main indications for endoscopy were chronic diarrhea (37.5%), screening endoscopy (23%), and abdominal pain (20%). Sixteen (29%) patients received medical treatment, while recession of symptoms was recorded in 19 of 43 symptomatic patients (44.1%). Twenty-three (41%) of the 56 patients underwent a second endoscopy and 15 (65.2%) cases had persistent endoscopic findings. Eleven (19.6%) of the 56 patients were eventually diagnosed with CD. The probability of CD diagnosis was significantly higher in patients with persistent symptoms (P=0.002) and endoscopic findings at follow up (P=0.038). Conclusions Nonspecific terminal ileitis generally has a benign clinical course. However, patients with persistent symptoms and endoscopic lesions are at increased risk for subsequent development of CD.

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Small Bowel Lesions Mimicking Crohn’s Disease

Sachar

2018

Curr Gastroenterol Rep

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The recognition of a granulomatous disease of the terminal ileum, distinct from tuberculosis, dates back over 85 years and perhaps much farther, but over the past decades, many other clinical pathologic entities have been described that are neither tuberculosis nor Crohn's eponymous regional enteritis. In recent years, the catalog of lesions mimicking Crohn's disease of the small bowel and proposals for differential diagnosis and treatment have expanded to include newly reported appendiceal pathology, primary cancers and lymphomas of the intestine, unexpected metastases from distant organs, unusual infections, vasculitides and other ischemic conditions, Behçet's disease, endometriosis, and drug reactions. A diagnosis of Crohn's disease should not be a reflex action in the face of small bowel structural or inflammatory lesions without consideration of pathology in adjacent organs, primary and metastatic lesions of the small intestine, infections, vascular diseases, infiltrative diseases, drug injury, or other "idiopathic" conditions.

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A Case of Small Bowel Diffuse Large B-cell Lymphoma Mimicking Crohn's Disease

Cited by 4 publications

References 18 publications

Rare Jejunal Large B-cell Lymphoma Mimicking a Crohn’s Disease Without Terminal Ileum Involvement

Rare Jejunal Large B-cell Lymphoma Mimicking a Crohn’s Disease Without Terminal Ileum Involvement

Isolated nonspecific terminal ileitis: prevalence, clinical evolution and correlation with metachronous diagnosis of Crohn’s disease: a retrospective study and review of the literature

Small Bowel Lesions Mimicking Crohn’s Disease

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