Ileo-Colonic Fistula Due to Diffuse Large B Cell Lymphoma: Unusual Presentation of a Rare Disease

Senyondo, Godson D.; Bella, S. Ait; Saleem, Atif; Mehdi, Sarah A; Sidhu, Jagmohan S.

doi:10.7759/cureus.12956

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…Tumor-induced intestinal fistulas are often caused by ovarian cancer and colon cancer [ 1 ]. Intestinal fistulas due to lymphoma are rarely encountered [ 2 ]. Fistula formation progresses through a chronic process.…”

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confidence: 99%

An unusual ileocecal tumor

Inoue

Kawamura

et al. 2022

Oxford Medical Case Reports

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We report the case of diffuse large B-cell lymphoma (DLBCL) with a fistula from the ileum to the cecum. A 57-year-old male came to the hospital complaining of abdominal pain. He underwent an abdominal computed tomography with contrast, which showed full-thickness wall thickening at the ileocecal region. He underwent a lower gastrointestinal endoscopy. No tumor was found at the ileocecal valve, and macroscopic findings were normal. The scope was advanced to the cecum, an additional outpouching was found. The outpouching appeared to be an ileocecal fistula. The diagnosis was DLBCL.

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confidence: 99%

An unusual ileocecal tumor

Inoue

Kawamura

et al. 2022

Oxford Medical Case Reports

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Primary Colorectal Diffuse Large B-cell Lymphoma: a Report of Eighteen Cases in a Tertiary Care Center

Vasconcelos

Araujo

Bernardo

et al. 2022

Preprint

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Primary colorectal diffuse large B-cell lymphoma (DLBCL) is very rare colon malignancy. Due to a possible delay in the diagnosis, it is important to know the main demographic and clinical characteristics of these patients. Retrospective analysis of 18 patients diagnosed with primary colorectal DLBCL during a 17-year period at the tertiary National Cancer Institute of Brazil (INCA) hospital. Demographic characteristics, tumor localization, HIV status, lactate dehydrogenase (LDH) levels, treatment modality and follow-up status were obtained from medical records. Survival was estimated from the date of diagnosis until death. There were 11 male and seven female patients in our cohort, the median age at diagnosis was 59.5 years and four patients were HIV positive. Tumor was mainly localized in the right proximal colon. Patients were treated with chemotherapy (CT) and/or surgical resection. Eleven patients died during a median follow-up of 59 months and the median survival time was 10 months for the whole group. Six or more cycles of CT (HR = 0.19; CI 95% 0.054–0.660, p = 0.009), low LDH levels (HR = 0.229; CI 95% 0.060–0.876, p = 0.031) and surgical resection (HR = 0.23; CI 95% 0.065–0.828, p = 0.030) were associated with reduced risk of death in univariate analysis. DLBCL affected more frequently middle-aged man and was primarily located in the right colon. These observations should be considered for differential diagnosis. Six cycles of CT, low LDH levels and surgical resection were associated with better survival. Our results are consistent with previous publications and address the importance of correct colorectal DLBCL diagnosis and treatment.

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Primary intestinal diffuse large B-cell lymphoma: novel insights and clinical perception

Chen,

Wang,

Liu

et al. 2024

Front. Oncol.

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BackgroundExtranodal Non-Hodgkin lymphoma (NHL) is more prevalent in the gastrointestinal (GI) tract than in other sites. This study aimed to explore the clinical features and prognostic factors of primary intestinal diffuse large B-cell lymphoma (PI-DLBCL), in order to provide new references for basic research and clinical diagnosis and treatment of the rare extranodal malignant lymphoma.MethodsThe clinical data of 88 patients with PI-DLBCL admitted to Fujian Medical University Union Hospital from June 2011 to June 2022 were retrospectively studied, the clinical and pathological features, diagnosis and treatment process and prognosis of PI-DLBCL were analyzed, and univariate and multivariate analysis of prognostic factors was carried out. The Kaplan-Meier method was used for survival analysis. Meanwhile, the latest literature from PubMed was retrieved to systematically discuss the research progress in the diagnosis and treatment of PI-DLBCL.ResultsAmong the 88 patients with PI-DLBCL included in this study, 60 cases were males (68.18%), 28 cases were females (31.82%), and 62 patients (70.45%) were complaining of abdominal pain, and the second most common clinical manifestation was changes in bowel habits in 16 (18.18%), with a median age of onset of 57 (17–82) years. The first-line treatment regimen was surgery combined with R-CHOP chemotherapy (56.82%). The median follow-up time was 72 (1–148) months, 51 (57.95%) of 88 patients with PI-DLBCL survived, 30 patients (34.09%) died, 7 patients (7.95%) were lost to follow-up, and the PFS rates of 1-year, 3-year and 5-year were 57.95%, 29.55% and 15.91%, and the OS rates of 1-year, 3-year and 5-year were 79.55%, 45.45% and 28.41%, respectively. The results of univariate Cox regression analysis showed that ECOG score, Lugano stage, B symptoms, IPI score, white blood cells, serum LDH, albumin, β2 microglobulin were the influencing factors of OS in PI-DLBCL patients, and ECOG score, Lugano stage, B symptoms, IPI score, white blood cells, serum LDH, albumin, β2 microglobulin were all the influencing factors of PFS in PI-DLBCL patients. The results of multivariate Cox analysis showed that Lugano stage may be an independent prognostic factor affecting OS and PFS in PI-DLBCL patients.ConclusionPI-DLBCL is more common in middle-aged and elderly men, clinical manifestations lack specificity, first-line treatment is mainly surgery combined with standard chemotherapy regimens. The Lugano stage may be an independent prognostic factor affecting OS and PFS in PI-DLBCL patients.

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Ileo-Colonic Fistula Due to Diffuse Large B Cell Lymphoma: Unusual Presentation of a Rare Disease

Cited by 3 publications

References 17 publications

An unusual ileocecal tumor

An unusual ileocecal tumor

Primary Colorectal Diffuse Large B-cell Lymphoma: a Report of Eighteen Cases in a Tertiary Care Center

Primary intestinal diffuse large B-cell lymphoma: novel insights and clinical perception

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