A CASE OF MALIGNANT LYMPHOMA OF THE SMALL INTESTINE PRESENTED WITH RICHTER'S HERNIA

Abstract

Malignant lymphoma of the small intestine are relatively rare which lack in specific symptoms and are often found out in an advanced stage. This paper reports a rare case of primary malignant lymphoma of the small intestine which caused an incaceratedinguinal hernia.
A 39-year-old man was admitted to the hospital bacause of a right lower abdominal tumor. He noticed the tumor about 7 months before and developed poor appetite and nausea 2 months before. On admission his abdomen was flat and soft, and an egg-sized tumor was palpated at the right inguineal region. No anemia nor jaundice was noted. There were no swollen superficial lymph nodes. CT-scan and selective contrast radiography of the small intestine indicated the incerated inguinal hernia of the small intestine. In laparotomy the ileum 5 cm to oral side from Bauhin valve was incarcerated in the right imternal inguinal ring. The patient underwent ileocecal resection and repair of the right inguinal hernia. The resected specimen showed that the incarcerated hernia was caused by the small intestinal tumor. Histological diagnosis was diffuse and large cell type of malignant lymphoma. Postoperatively CHOP regimen added and the patient is strictly followed up on an ambulant basis.