Enterovesical fistula caused by non-Hodgkin’s lymphoma of the ileum: report of a case

Abstract

We herein present a rare case of enterovesical fistula caused by ileal non-Hodgkin's lymphoma. A 75-year-old Japanese male presented with macrohematuria at Kosei General Hospital in December 2010. An egg-sized mass was palpable in his right lower abdominal region, and computed tomography (CT) revealed that the ileal tumor had invaded the right posterior wall of the urinary bladder (UB). A histopathological examination of a CT-guided needle biopsy specimen revealed diffuse large B-cell lymphoma involving the ileum and the UB. Thereafter, fecaluria appeared. A transurethral catheter was put in place, and there were no symptoms of cystitis. The patient received chemotherapy for the lymphoma, which produced a partial response. However, the fecaluria continued, and an examination of the small intestine with contrast revealed a thick and irregular wall of the ileum and a fistula between the ileum and UB. A partial resection of the ileum and a partial cystectomy were carried out in April 2011. The surgical specimen demonstrated two tumors 5 cm apart in the ileum, measuring 4.5 × 7 and 4 × 3 cm in size. The proximal tumor had directly invaded the UB and formed an ileovesical fistula. The patient made a good recovery and was doing well 5 months after the surgery without any evidence of recurrence.

Enterovesical Fistula in a Lymphoma Patient Revealed by FDG PET/CT With an Oral Contrast Agents

“…Enterovesical fistula as a rare complication typically arises from diverticular disease, Crohn disease, colon malignancy, radiotherapy, or trauma. 1,2 The imaging features of enterovesical fistula as well as other fistulas including gastrosplenic fistula, 3 vesicovaginal fistula, 4 and esophagopulmonary fistula 5 have been reported in previous FDG PET/CT studies. To clearly describe the presence of enterovesical fistula, several techniques such as early dynamic scanning, 6 diuresis, 7 or intravenous contrast 8 have been used.…”

“…Subsequent cystography ( E ) confirmed the connection between colon and the bladder (arrow). Enterovesical fistula as a rare complication typically arises from diverticular disease, Crohn disease, colon malignancy, radiotherapy, or trauma 1,2 . The imaging features of enterovesical fistula as well as other fistulas including gastrosplenic fistula, 3 vesicovaginal fistula, 4 and esophagopulmonary fistula 5 have been reported in previous FDG PET/CT studies.…”

Rare intestinal fistula caused by primary lymphoma of the gastrointestinal tract

“…[ 6 ] According to the literature, intestinal fistula caused by lymphoma could affect the adjacent loops, the bladder and even the aorta. [ 7 – 9 ]…”

Unusual cause of Dysuria - Lymphoma of Terminal Ileuim

“…10 Cases have also been reported of patients presenting with in ltration of the bladder wall by the small bowel tumour, resulting in the formation of an enterovesical stula. 11,12 In these cases, the patients presented with haematuria, with one reporting concurrently having a month-long history of dysuria.…”