2024 Volume 77 Issue 7 Pages 407-411
An 84-year-old female was admitted to our hospital with a chief complaint of abdominal pain and vomiting. Emergency operation was performed as abdomen CT suggested gastrointestinal perforation. During the procedure, many tumorous lesions of the small intestine were found, and one of them was perforated. We suspected malignant lymphoma of the small intestine with perforation, and so performed partial resection of the small intestine, and parts of the specimens were examined by flow cytometry in the fresh state, without formalin fixation. On post operative day 4, flow cytometry revealed that large B-cell antigen was strongly positive, and combined with the pathological examination, we finally diagnosed diffuse large B-cell lymphoma of the small intestine. She was discharged 20 days after emergency surgery for chemotherapy, without any complications. Malignant lymphoma of the small intestine is sometimes diagnosed after surgery for gastrointestinal perforation, and is considered to have a poor prognosis. Therefore, rapid diagnosis of the type of lymphoma and introduction of chemotherapy might be needed. It is suggested that examination of the surgical specimen by flow cytometry in the fresh, not in formalin, may be useful for the rapid diagnosis of the type of malignant lymphoma.
