A case of t cell lymphoma of the small intestine presenting with perforated peritonitis

Abstract

An 82-year-old woman was admitted because of severe abdominal pain. She had a fever and severe tenderness in her right abdomen. Blood tests revealed a high inflammation level. Abdominal CT showed a large amount of free air and a small amount of ascites ; the small intestine with a thick wall crossed the anterior side of the ascending colon. A small intestinal tumor and perforation were diagnosed. We operated emergently on the same day. The jejunum was found to have a thick wall ; there were three perforations. A partial resection of the jejunum was done. An infiltration of small to medium-sized atypical lymphocytes was seen in the jejunum wall ; there were many CD3-positive T cell lymphoma cells. The patient's status deteriorated gradually, and she died of aspiration pneumonia 80 days after the operation. In patients with a tumor and perforation of the small intestine, the possibility of malignant lymphoma should be considered.