Abstract
We report a case of nodal malignant lymphoma at a colostomy with lymph nodes dissection for a carcinoma of the descending colon which was thought very rare.
An 88-year-old man was admitted to the hospital for close exploration of a left lower abdominal pain. Except a mild hepatic impairment on biochemical examinations, no abnormalities including blood parameters were noted and tumor markers were in normal limits. Barium enema study revealed a whole-circumferential stricture in the descending colon, and a colonoscopic fiber visualized a type 2tumor. Biopsy revealed adenocarcinoma. We thought that the patient developed ileus like symptoms due to the carcinoma of the descending colon which caused the abdominal pain, and performed an operation. Upon laparotomy, no ascites, hepatic and lymph node metastases, nor peritoneal dissemination was present. Resection of the descending colon with regional lymph nodes dissection (D3) was performed. The resected material revealed that the tumor was 4×2cm in size, type 2, and moderately differentiated adenocarcinoma of ss, ly1, v1, ow-, and aw-. No regional lymph node mertastases were noted, but infiltrations of lymphoma cells to lymph nodes of #242 and #232 were confirmed. L-26, KP-1, BerH-2, and UCHL-1 stainings were done, resulting in a positive response to L-26. The diagnosis of B-cell type, diffuse, and large was achieved.
