Abstract
A case of primary malignant lymphoma arising from the terminal ileum is described. A 43-year-old man admitted because of abdominal pain and melena. Barium enema and colonoscopy revealed a tumor intussuscepting from the terminal ileum into the cecum (Figure 1 and 2). The tumor was gradually replaced into the ileum through the ileocecal valve by means of overinsufflation of air and pushing with colonofiberscope (Figure 3, 4 and 5). Finally, the intussusception was reduced and abdominal pain disappeared. Histological examination of biopsied specimen from the tumor revealed malignant lymphoma (Figure 6). Because of disappearance of the symptoms, it became possible to have a time for further examinations. Abodminal CT showed an isodensity mass in which the density increased with contrast enhancement in the ascending colon (Figure 7). Right hemicolectomy and ileotomy were performed because of recurrence of intussusception. The resected specimen showed a mass with relatively irregular surface in the terminal ileum (Figure 8). Histological examination of the tumor revealed diffuse type of mlignant lymphoma (Figure 9 and 10). Lymphoma was not found in any other sites of the body including mesenteric lymph nodes. Malignant lymphoma originated in the small intestine and diagnosed prior to surgery is relatively rare. A brief review of literatures on small intestinal malignant lymphoma and reduction of intussusception by colonofiberscopy is given.
