全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Acute Appendicitis in a Man Undergoing Therapy for Mantle Cell Lymphoma

DOI: 10.1155/2012/868151

Full-Text   Cite this paper   Add to My Lib

Abstract:

A 71-year-old man was diagnosed with an aggressive mantle cell lymphoma and was started on six cycles of R-CHOP chemotherapy. Approximately two weeks after starting his first cycle of chemotherapy, he complained of severe right lower quadrant abdominal pain, and an abdominal CT scan demonstrated an enlarged appendix with evidence of contained perforation. The man underwent open appendectomy for acute appendicitis and recovered. The appendectomy specimen was submitted for routine pathological analysis. There was histologic evidence of perforation in association with an inflammatory infiltrate with fibrin adhered to the serosal surface; scattered small lymphoid aggregates were present on the mucosal surface. Although the lymphoid aggregates in the submucosa and lamina propria were rather unremarkable by routine histologic examination, immunohistochemistry revealed the lymphocytes to be predominantly Cyclin D1-overexpressing B cells. To our knowledge, this is the first reported case of acute appendicitis in association with appendiceal involvement by mantle cell lymphoma. 1. Introduction An appendectomy specimen collected in a clinical scenario supportive of acute appendicitis is a common sample received in gross rooms for routine pathology analysis. Indeed, the relative simplicity of the specimen makes it a rite of passage for medical students and new residents first approaching the pathology gross examination. While the pathologic examination of the appendix typically supports the clinical impression of acute appendicitis, routine histopathological analysis plays a crucial role in evaluating for occult pathologic conditions, including neoplasia. Carcinomas are the most frequent neoplasms encountered in the appendix; however, other less frequently encountered neoplasms include carcinoid tumors and lymphomas [1]. Lymphoma involving the appendix in association with acute appendicitis has been rarely described previously, with the majority of cases being Burkitt or large B-cell lymphoma [2–15]. Here we report an unusual example of acute appendicitis presenting in a patient undergoing treatment for mantle cell lymphoma. 2. Case Report A 71-year-old man complained of a two week history of right-sided abdominal pain that started after he began his first round of chemotherapy with R-CHOP with pegfilgrastim for mantle cell lymphoma. He presented to the emergency department (ED) after he developed severe (9 out of 10) right lower quadrant abdominal pain, approximately 17 days after starting chemotherapy. A physical examination in the ED revealed tenderness most

References

[1]  L. M. Sieren, J. N. Collins, L. J. Weireter et al., “The incidence of benign and malignant neoplasia presenting as acute appendicitis,” The American Surgeon, vol. 76, no. 8, pp. 808–811, 2010.
[2]  J. M. Baek, J. H. Lee, G. Y. Sung, and D. S. Lee, “Primary appendiceal lymphoma presenting as acute appendicitis,” The American Surgeon, vol. 77, no. 5, pp. E87–E88, 2011.
[3]  N. Bhardwaj, S. K. Bains, G. Ortonowski, and P. Murphy, “A case of Burkitt's lymphoma presenting as suspected acute appendicitis,” African Journal of Paediatric Surgery, vol. 7, no. 3, pp. 214–215, 2010.
[4]  E. Cigerciogullari, H. Aki, T. Celkan, and S. Dervisoglu, “Appendiceal lymphoma presenting as acute appendicitis: a case report,” Virchows Archiv, vol. 451, article 444, 2007.
[5]  T.-Y. Fu, J.-S. Wang, and H.-H. Tseng, “Primary appendiceal lymphoma presenting as perforated acute appendicitis,” Journal of the Chinese Medical Association, vol. 67, no. 12, pp. 629–632, 2004.
[6]  S. A. Ghani, N. Syed, and P. E. Tan, “A rare cause of acute appendicitis: Burkitt's lymphoma of the appendix,” Medical Journal of Malaysia, vol. 39, no. 4, pp. 311–313, 1984.
[7]  J. Huh, S. M. Hong, S. S. kim et al., “Angiocentric lymphoma masquerading as acute appendicitis,” Histopathology, vol. 34, no. 4, pp. 378–380, 1999.
[8]  S. Jaganmohan, R. Chauvin, G. Burton, et al., “Primary Burkitt's lymphoma of the appendix presenting as acute appendicitis,” American Journal of Gastroenterology, vol. 101, pp. S146–S147, 2006.
[9]  D. M. Malicki, Y. K. Suh, G. N. Fuller, and S. S. Shin, “Angiotropic (intravascular) large cell lymphoma of T-cell phenotype presenting as acute appendicitis in a patient with acquired immunodeficiency syndrome,” Archives of Pathology and Laboratory Medicine, vol. 123, no. 4, pp. 335–337, 1999.
[10]  G. Muller, J. L. Dargent, V. Duwel et al., “Leukaemia and lymphoma of the appendix presenting as acute appendicitis or acute abdomen. Four case reports with a review of the literature,” Journal of Cancer Research and Clinical Oncology, vol. 123, no. 10, pp. 560–564, 1997.
[11]  A. A. Nanji and F. H. Anderson, “Burkitt's lymphoma with acute appendicitis,” Archives of Surgery, vol. 118, no. 11, p. 1352, 1983.
[12]  S. K. Ratuapli, S. Murarka, K. A. Miller, J. C. Ferraro, and H. Zafar, “Epstein Barr Virus-positive large T-cell lymphoma presenting as acute appendicitis 17 years after cadaveric renal transplant: a case report,” Journal of Medical Case Reports, vol. 5, article 5, 2011.
[13]  M. H. Shiwani, M. Al-Hashmi, and J. R. Ausobsky, “Acute appendicitis associated with malignant lymphoma: a case report,” Gastroenterology, vol. 114, supplement 1, article A679, 1998.
[14]  M. H. Shiwani, “Primary malignant lymphoma of the appendix associated with acute appendicitis,” Journal of the College of Physicians and Surgeons, vol. 16, no. 1, pp. 79–80, 2006.
[15]  S.-M. Wang, F.-C. Huang, C.-H. Wu, S.-F. Ko, S.-Y. Lee, and C.-C. Hsiao, “Ileocecal Burkitt's lymphoma presenting as ileocolic intussusception with appendiceal invagination and acute appendicitis,” Journal of the Formosan Medical Association, vol. 109, no. 6, pp. 476–479, 2010.
[16]  S. H. Swerdlow, E. Campo, N. L. Harris, et al., WHO Classification of Tumours of Hematopoietic and Lymphoid Tissues, International Agency for Research on Cancer, Lyon, France, 2008.
[17]  M. E. Williams, J. M. Connors, M. H. Dreyling et al., “Mantle cell lymphoma: report of the 2010 Mantle Cell Lymphoma Consortium Workshop,” Leukemia and Lymphoma, vol. 52, no. 1, pp. 24–33, 2011.
[18]  T. Kodama, K. Ohshima, K. Nomura et al., “Lymphomatous polyposis of the gastrointestinal tract, including mantle cell lymphoma, follicular lymphoma and mucosa-associated lymphoid tissue lymphoma,” Histopathology, vol. 47, no. 5, pp. 467–478, 2005.
[19]  A. Bassarova, A. Tierens, G. F. Lauritzsen, A. Fossa, and J. Delabie, “Mantle cell lymphoma with partial involvement of the mantle zone: an early infiltration pattern of mantle cell lymphoma?” Virchows Archiv, vol. 453, no. 4, pp. 407–411, 2008.

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133