A Case of Non-Hodgkin’s Lymphoma of the Appendix

Abstract

A 5-year-old girl was brought to an emergency hospital owing to intermittent abdominal pain. Her laboratory data indicated acute inflammation, and contrast-enhanced abdominal CT showed a right lower abdominal mass involving the small intestine, which suggested a malignant disease rather than appendiceal abscess. She was referred to our hospital for further treatment. Color Doppler ultrasonogram showed a right lower abdominal mass 5 cm in diameter and mixed liquid and solid components with rich blood flow signals. MRI findings suggested that this mass originated from the intestinal tract, and positron-emission tomography/computed tomography (PET-CT) revealed hypermetabolism in the tumor, paraaortic lymph nodes and the Douglas pouch. Surgery was carried out with the suspected diagnosis of intestinal lymphoma with metastasis. After laparoscopic mobilization of the ileocecal lesion, the primary tumor arising from the appendix with direct invasion to the ileum was resected en bloc by open abdominal surgery. After confirmation of the pathological diagnosis of non-Hodgkin’s lymphoma of the appendix, adjuvant chemotherapy was started on the fifth postoperative day. PET-CT followed by four months of chemotherapy showed no accumulation of FDG in the metastatic lesions. She was doing well eight months after surgery.