Abstract
Primary malignant lymphoma in the intestinal tract is a rare disease, with an incidence which is believed to be 1-1.7% that of intestinal cancer. The site where it commonly develops is the ileocoecum, and it occurs solitary in most cases.
Its differential diagnosis from cancer prior to surgery is very difficult even using radiography or endoscopy. Although surgical therapy is, as a rule, applied as treatment, as in the case of cancer, postoperative combined therapy is important in that the lesions have already advanced before surgery in many cases and that they are highly sensitive to drug therapy and radiotherapy.
In our patient, a 49-year-old man, with double primay malignant lymphomas in the jejunum and cecum, the lesions in the cecum were preoperatively diagnosed on biopsy by endoscopy of the large intestine. Remission was induced by internal treatment. However, because symptoms of ileus appeared, palliative resection was undertaken.
The lesion was histologically diagnosed to be the diffuse, large-cell type according to the LSG classification, and to be considerably malignant. However, re-resection for relapse of the lesion in the intestinal tract and combined treatment involving drug therapy and radiotherapy for relapse of the lesion in the lymph nodes were very effective, resulting in a long-term survival of more than three years.
