Primary Gastrointestinal Diffuse Large B-cell Lymphoma

Abstract

Primary gastrointestinal lymphoma is a rare neoplasm that accounts for less than 5% of all gastrointestinal malignancies. We present a case of a 37-year-old woman positive for human immunodeficiency virus who presented with abdominal pain and vomiting for three months. She underwent endoscopic biopsy and was found to have high-grade diffuse large B-cell lymphoma in the jejunum. This report discusses her treatments and includes a brief literature review highlighting the rarity of this entity, the etiological agents implicated in its pathogenesis, and the lack of specific guidelines for treatment.

A rare case of Small Intestinal (Duodenal) diffuse large B-cell lymphoma (DLBL) in an elderly patient presented with gastrointestinal bleeding

“…[9] Since the clinical features of small intestinal DLBCL are highly nonspecific, an endoscopy is usually performed to identify any suspicious lesions and to obtain biopsies. [10] The tumor may appear as a circumferential bulky mass in the intestinal wall and may ulcerate and perforate into the adjacent mesentery. [11] The diagnosis of DLBCL can be established based on an excisional lymph node biopsy or by analyzing samples obtained from an affected organ via an incisional biopsy.…”

“…[4] Once the diagnosis of DLBCL is established, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) can be used to stage the disease. [10] Due to the low incidence of de novo duodenal DLBCL, there are no guidelines available for the treatment of small intestinal DLBCL and the optimal treatment remains unknown. Patients with advanced diseases require more aggressive treatment.…”

“…The most commonly used chemotherapy regimen is R-CHOP, which is a combination of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone. [9,10,14] In patients with unfavorable prognostic factors, DA-EPOCH-R (dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab) may also be a beneficial treatment option [10,15]. Response to treatment is measured using data collected from the post-treatment history, physical, and imaging (PET/CT) scan results.…”