AI Summary & Key Takeaways
AI InsightThe diagnosis of the case was diffuse large B-cell lymphoma.The possibility of the presence of this disorder, although rare, is emphasized here for patients applying to the hospital with the signs and symptoms of Crohn’s disease.
📌 3 Key Takeaways
Abstract
Multifocal and skip involvement is quite a rare developmental pattern for primary gastrointestinal lymphomas. A 25-year-old male patient with diffuse large B-cell lymphoma of the small intestine, with macroscopic features and clinical aspects imitating Crohn’s disease and attracting attention with cobblestone-like appearance, is presented herein together with the clinical and pathological features. Multiple ulcerated lesions were also observed infiltrating the serosa with polypoid appearance, 2.5 cm in largest diameter, within the resected jejunoileal specimen, which displayed patchy, healthy-appearing mucosal areas. In microscopic examination, a tumoral infiltration was observed comprised of pleomorphic, atypical lymphoid cells with abundant eosinophilic cytoplasm, marked nucleoli and vesicular nuclei. A B-cell phenotype immunoreaction was observed by vimentin, LCA, CD20, and CD79a in those atypical cells. The diagnosis of the case was diffuse large B-cell lymphoma.The possibility of the presence of this disorder, although rare, is emphasized here for patients applying to the hospital with the signs and symptoms of Crohn’s disease.
Özet
Multifokal ve atlamalı tutulum, primer gastrointestinal lenfomalar için oldukça nadir görülen bir gelişim paternidir. Klinik ve makroskopik özellikleriyle Crohn hastalığını taklit eden kaldırım taşı görünümü ile dikkat çeken bir ince barsağın multifokal diffüz büyük B hücreli lenfoma olgusu, klinik ve patolojik özellikleri ile beraber sunulmuştur. 25 yaşındaki erkek olgunun jejunoileal rezeksiyon materyalinde, arada sağlam görünümde mukoza alanları izlenen, en büyüğü 2,5 cm çapında olan, ülsere, serozayı da infiltre eden polipoid görünümde multipl lezyonlar izlendi. Mikroskopik incelemede, belirgin nükleollü, veziküler nükleuslu, geniş eozinofilik sitoplazmalı, pleomorfik, atipik karakterde lenfoid hücrelerden oluşmuş tümöral infiltrasyon gözlendi. Bu atipik hücrelerde vimentin, LCA, CD20, CD79a ile B hücre fenotipinde immün reaksiyon izlendi. Olguya, diffüz büyük B hücreli lenfoma tanısı verildi. Crohn hastalığı belirti ve bulguları ile başvuran hastalarda nadir de olsa bu antitenin olabileceği vurgulanmıştır.