A Complicated Case of Diffuse Large B-Cell Lymphoma in an Elderly Presenting with Massive Gastrointestinal Bleeding Successfully Treated with R-mini CHOP

Sunggoro, Agus Jati; Dwianingsih, Ery Kus; Utomo, Bambang Purwanto; Purwanto, Ibnu

doi:10.1159/000512826

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…The addition of rituximab has resulted in a reduced need for surgical intervention. In cases of localized disease in the small intestine, there may still be a surgical role in combination with R-CHOP [12]. Most surgeries performed in cases of intestinal NHL are emergency laparotomies [13], similarly to the above case.…”

Section: Discussionmentioning

confidence: 96%

Perforated small bowel lymphoma presenting as an acute abdomen and requiring emergency surgery, a case report

Finnerty,

O’Connell,

Sheehan

et al. 2024

Preprint

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Introduction: Diffuse large B cell lymphoma (DLBCL) is the most common type of non-Hodgkin’s lymphoma (NHL). It accounts for most lymphomas affecting the gastrointestinal (GI) tract. Extranodal sites include the stomach, small intestine, and ileocecal region. Mesentery is commonly involved. Symptoms are generally non-specific but may present as surgical emergencies secondary to perforation or ischemia. Case presentation: This case report discusses an emergency presentation of a DLBCL in a 74-year-old male. On examination, he had a palpable mass in the mid abdomen. Cross sectional computed tomography (CT) demonstrated a large intra-peritoneal mass, 20cm in transverse diameter with a smaller more proximal mass. Prior to treatment initiation he represented with an acute abdomen. He underwent an emergency laparotomy. Encasement of the SMA (Superior mesenteric artery) produced ischemia and subsequent perforation of a segment of distal small bowel. This required resection and formation of an end ileostomy. The 20cm mass involving the proximal mesentery was left in situ as safe surgical removal was not feasible. Conclusion: We conclude that in the case of mesenteric lymphoma, surgical intervention should address the compromised bowel segment and accompanying contamination only to avoid vascular risks or potential for extensive small bowel resection. When stabilized the definitive treatment should be in the form of systemic chemotherapy.

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Section: Discussionmentioning

confidence: 96%

Perforated small bowel lymphoma presenting as an acute abdomen and requiring emergency surgery, a case report

Finnerty,

O’Connell,

Sheehan

et al. 2024

Preprint

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show abstract

“…The proposed first-line regimen for extranodal gastrointestinal DLBCL is the use of CHOP or R-CHOP chemotherapy protocols. Most of the reports give a significant advantage of the rituximab addition to the CHOP protocol in terms of significantly greater overall survival and progression-free survival [13,14].…”

Section: Discussionmentioning

confidence: 99%

Extranodal Diffuse Large B-Cell Lymphoma of the Small Bowel in Female Patient Causing Intestinal Obstruction: A Case Report

Nikolovski¹,

Trajkova²,

Dukovski³

et al. 2022

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Diffuse large B cell lymphoma is the most common extranodal non-Hodgkin lymphoma of the small intestine accounting for more than 50% of cases. Forty percent of these cases initially present with small bowel obstruction. Therefore, the diagnosis is usually established after surgery for bowel obstruction. The treatment is then continued with a certain chemotherapy regimens. We present a case of a 46-years-old female patient with signs of small bowel obstruction due to previously undiagnosed diffuse large B-cell lymphoma. Postoperatively, the patient was treated with 7 cycles of R-CHOP protocol and complete response was achieved in the short follow-up period.

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“…Tất cả các trường hợp u lympho tế bào B lớn lan tỏa ở nghiên cứu này đều có hình thái lan tỏa (100%), hầu hết các trường hợp tế bào u có kích thước lớn (79,3%). Theo y văn cũng như các nghiên cứu trước đây, u lympho tế bào B lớn lan tỏa ở dạ dày -ruột có đặc điểm mô bệnh học giống như u lympho tại hạch với các tế bào u có kích thước lớn, hình thái xâm nhập lan tỏa [13], [14].…”

Section: đặC đIểm Mô Học Và Tế Bào Các U Lympho Dạ Dày -Ruột Thường Gặpunclassified

A study on diagnosis and classification of gastrointestinal lymphoma based on histopathology and immunohistochemistry

Nguyen Duy,

Ta Van,

Nguyen Tran Bao

et al. 2023

JMP

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Background: WHO 2019 classification makes important histopathology additions to gastrointestinal lymphoma. This study aimed to investigate the role of histopathology and immunohistochemistry in the diagnosis and classification of gastrointestinal lymphomas. Materials and method: We investigated 141 patients from three tertiary referral hospitals with primary malignant lymphoma of the gastrointestinal tract. The lesions were evaluated and analyzed by using histopathology to classify the prevalent histopathological patterns of gastrointestinal lymphoma according to the WHO 2019 classification based on histopathology and immunohistochemistry. Results: 90.8% of gastrointestinal lymphomas were lymphoid infiltrates on histopathology. The most common type was diffuse large B-cell lymphoma (DLBCL) in which activated -B cell (ABC) subtype accounted for 54%, and germinal-center B-cell (GCB) accounted for 46%. In the second place was mucosa-associated lymphoid tissue (MALT lymphoma) accounting for 24%, followed by follicular lymphoma at 10.6%. Histopathology can orient to the diagnosis of DLBCL and MALT with sensitivity at 31% and 29%, respectively. Conclusions: Orientation based on histopathology of those tumor classifications is challenging. However, the combination of histopathology and immunohistochemistry could help to classify the majority of gastrointestinal lymphoma types. Key words: Gastrointestinal lymphomas, DLBCL, MALT.

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A Complicated Case of Diffuse Large B-Cell Lymphoma in an Elderly Presenting with Massive Gastrointestinal Bleeding Successfully Treated with R-mini CHOP

Cited by 4 publications

References 13 publications

Perforated small bowel lymphoma presenting as an acute abdomen and requiring emergency surgery, a case report

Perforated small bowel lymphoma presenting as an acute abdomen and requiring emergency surgery, a case report

Extranodal Diffuse Large B-Cell Lymphoma of the Small Bowel in Female Patient Causing Intestinal Obstruction: A Case Report

A study on diagnosis and classification of gastrointestinal lymphoma based on histopathology and immunohistochemistry

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