Diffuse Large B Cell Lymphoma of the Mesentery: An Unusual Presentation and Review of the Literature

Salemis, Nikolaos S.; Gourgiotis, Stavros; Tsiambas, Evangelos; Karagkiouzis, Grigorios; Νάκος, Γεώργιος; Karathanasis, Vasilios

doi:10.1007/s12029-009-9114-7

Cited by 15 publications

(12 citation statements)

References 20 publications

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“…In the small bowel, a polypoid form, multiple nodules, infiltrating form, and endoexoenteric form with excavation and fistulization have been described [9]. In addition, a mesenteric invasive form has been reported to occur secondary to direct extension from a bulky mesenteric nodal enlargement [9,10]. Myung et al [11] classified ileocolic lymphomas according to colonoscopic findings into fungating, ulcerative, infiltrative, ulcerofungating, and ulceroinfiltrative types.…”

Section: Discussionmentioning

confidence: 99%

Small Bowel Intussusception Due to a Primary Non-Hodgkin's Lymphoma. An Unusual Presentation and Clinical Course

Salemis¹,

Tsiambas²,

Liatsos³

et al. 2010

J Gastrointest Canc

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Adult jejuno-jejunal intussusception due to primary non-Hodgkin's lymphoma is a rare clinical entity. A high index of suspicion is needed as symptoms and signs are not pathognomonic. Appropriate investigations can lead to a prompt preoperative diagnosis. Resection without prior reduction is the treatment of choice. Our patient's refusal of postoperative adjuvant chemotherapy likely resulted in relapse of the disease in another part of the gastrointestinal tract.

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Section: Discussionmentioning

confidence: 99%

Small Bowel Intussusception Due to a Primary Non-Hodgkin's Lymphoma. An Unusual Presentation and Clinical Course

Salemis¹,

Tsiambas²,

Liatsos³

et al. 2010

J Gastrointest Canc

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“…The benefits of RT in terms of LC and PFS have been demonstrated in multiple randomized and retrospective studies [8–13, 16] and seem to be greatest for patients with localized disease, bulky disease, or skeletal involvement [7, 14, 38]. The location within the abdomen allows mesenteric lymphomas to reach a large size before causing any clinical symptoms that lead to diagnosis [27]. Therefore, it is not uncommon for these patients to present with masses that, by size criteria, qualify as bulky.…”

Section: Discussionmentioning

confidence: 99%

“…Lymph nodes in the mesentery a common location for NHL, identified in 30–50% of all patients [27, 28]. Conventional 3-dimensional (3D)-radiation to the whole abdomen ensures that the tumor is included in the treatment volume, but this approach can cause undesirable side-effects such as nausea and diarrhea.…”

Section: Introductionmentioning

confidence: 99%

Hitting a Moving Target: Successful Management of Diffuse Large B-cell Lymphoma Involving the Mesentery With Volumetric Image-guided Intensity Modulated Radiation Therapy

Yoder

Gunther

Milgrom

et al. 2019

Clinical Lymphoma Myeloma and Leukemia

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Introduction: We report successful treatment of mesenteric diffuse large B-cell lymphoma (DLBCL) using localized involved site radiation therapy (ISRT), intensity modulated radiation therapy (IMRT), and daily CT-image guidance. Methods: Patients with mesenteric DLBCL treated with RT between 2011 and 2017 were reviewed. Clinical and treatment characteristics were analyzed for an association with local control (LC), progression free survival (PFS) and overall survival (OS). Results: Twenty-three patients were eligible. At diagnosis, the median age was 52 years (38–76), and 57% (n=13) had stage I/II DLBCL. All patients received frontline chemotherapy (ChT) (R-CHOP, n=19; dose-adjusted R-EPOCH, n=4) with median 6 cycles. Prior to RT, salvage ChT for refractory DLBCL was given to 43% (n=10) and autologous stem cell transplantation was administered in 13% (n=3). At the time of RT, PET-CT revealed five-point scale (5PS) of 1–3 (48%, n=11), 4 (9%, n=2), and 5 (44%, n=10). All patients received IMRT, daily CT imaging and ISRT. The median RT dose was 40 Gy (16.2–49.4). Relapse or progression occurred in 22% (n=5). At median follow-up of 37 months, the 3-year LC, PFS and OS rates were 80%, 75% and 96%, respectively. Among patients treated with RT after complete metabolic response to frontline ChT (n=8), 3-year PFS was 100%, compared to 61% for patients with history of chemorefractory DLBCL (n=15, p=0.055). Four of the five relapses occurred in patients with 5PS of 5 prior to RT (p=0.127). Conclusion: Mesenteric involvement of DLBCL can be successfully targeted with localized ISRT fields using IMRT and daily CT-image guidance.

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“…Systemic symptoms (fever, night sweats, weight loss) indicate advanced-stage disease. Complications such as intestinal obstruction, perforation and hemorrhage are rare [10]. Mesenteric lymphomas may remain asymptomatic for years, even when the tumor is voluminous.…”

Section: Tumors Of Lymphatic Origin Cystic Lymphangioma (Cl)mentioning

confidence: 99%

Mesenteric tumors: Diagnosis and treatment

Dufay

Abdelli

Pennéc

et al. 2012

Journal of Visceral Surgery

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Undifferentiated carcinoma is a usually aggressive, malignant epithelial neoplasm composed of atypical cells which do not display evidence of glandular, squamous, or urothelial cell differentiation.1 Mesenteric tumors are rare and consist of a heterogeneous group of lesions. Among them undifferentiated carcinoma of the mesentery is very very rare entity. Here we present a case of undifferentiated carcinoma of the mesentery in a 51 year old male admitted to the department of surgery, Shaheed Suhrawardy Medical College Hospital (ShSMCH) with rapidly increasing huge abdominal lump, central abdominal pain and weight loss. Ultrasound of the whole abdomen and CT scan of whole abdomen reports were suggestive of retroperitoneal mass. Exploratory laparotomy was done and specimen sent for histopathology. Reports were suggestive of malignant mesothelioma whereas immunohistochemistry report revealed undifferentiated carcinoma of the mesentery. To the best of our knowledge, there was no report of undifferentiated carcinoma of the mesentery in a 51 year old male from Bangladesh or any other country, 2013;5(2):114-116]

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Diffuse Large B Cell Lymphoma of the Mesentery: An Unusual Presentation and Review of the Literature

Abstract: Although chemotherapy is the treatment of choice for diffuse large B cell lymphoma, in some cases radical surgery has a role in establishing a definitive diagnosis.

Cited by 15 publications

References 20 publications

Small Bowel Intussusception Due to a Primary Non-Hodgkin's Lymphoma. An Unusual Presentation and Clinical Course

Small Bowel Intussusception Due to a Primary Non-Hodgkin's Lymphoma. An Unusual Presentation and Clinical Course

Hitting a Moving Target: Successful Management of Diffuse Large B-cell Lymphoma Involving the Mesentery With Volumetric Image-guided Intensity Modulated Radiation Therapy

Mesenteric tumors: Diagnosis and treatment

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