INTUSSUSCEPTED MALIGNANT LYMPHOMA OF THE TERMINAL ILEUM CONFIRMED WITH COLONOSCOPIC BIOPSY : REPORT OF A CASE

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A rare case of intussusception caused by a malignant lymphoma which was diagnosed before surgery is reported. A 45-year-old male was admitted to our hospital complaining of intermittent abdominal pain over the previous 3 months. Barium enema examination showed a spheroid tumor in the ileocecal region. Abdominal sonography, CT, and a superior mesenteric arteriogram revealed intussusception caused by the tumor. Colonoscopy revealed a round mass with redness and erosion, and invaginated ileac mucosa. Since intact mucasa was observed on the surface, the tumor appeared to be located in the submucosa. Therefore, biopsy specimens were carefully obtained from the part of the erosion involving submucosal tumor tissue. The lesion was diagnosed histologically as malignant lymphoma. From these findings, we concluded that this was a case of ileocolic intussusception caused by a malignant lymphoma of the terminal ileum. An operation was performed. The tumor (5 x 4 x 4cm) was located in the ileum 15cm from the ileocecal valve and histological examination of resected tissue revealed a diffuse type of malignant lymphoma. It is well known that most cases of intussusception in adults are due to intestinal tumors. Colonoscopic examination is strongly recommended to determine an accurate diagnosis before surgery in cases of intussusception in adults.
社団法人日本消化器内視鏡学会の論文