A Case of Intestinal Malignant Lymphoma with Multiple Lesions Associated with an Intestinal Obstruction

Abstract

An 83-year-old woman who had undergone cholecystectomy for cholecystolithiasis was admitted to our hospital with abdominal distension and vomiting. The patient was conservatively treated with parenteral nutrition and antibiotics, but the symptoms failed to resolve in response to decompression of the bowel. Because she had previously undergone cholecystectomy, an adhesive intestinal obstruction was the most likely diagnosis and surgery was performed. The intraoperative findings revealed four palpated tumors of the small intestine. A partial resection of the small intestine was performed. The tumor was diagnosed as a diffuse large B-cell lymphoma based on the histopathological findings. Chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone (R-CHOP) was therefore started. Although cases of intestinal malignant lymphoma with multiple lesions are rare, we should consider them for the patients with unidentified and repeated ileus.