A Case of Primary Malignant Lymphoma of the Appendix

Naoki Imai, Hiroshi Tanabe, Susumu Watanabe

Department of Surgery, General Kizawa Memorial Hospital

A case of primary malignant lymphoma of the appendix is reported, together with a review of the cases in the Japanese literature. A 42-year-old man complaining of lower abdominal pain consulted a neighborhood physician. He was subsequently referred to us with the diagnosis of acute appendicitis. We diagnosed his condition as perforative appendicitis, and thus performed an appendectomy. The post-operative histological diagnosis was non-Hodgkin's lymphoma, diffuse, large cell type according to the LSG classification. On the 10th day after surgery, a right hemicolectomy with regional lymphnode excision was performed for radical treatment, but no malignant lymphoma was found in any of the specimens. Primary malignant lymphoma of the appendix is an extremely rare disease, and to date only 21 cases have been reported in the Japanese literature. Most of the cases were diagnosed as acute appendicitis, and appendectomy was performed. The definite diagnosis was obtained by post-operative histological examination. Radical resection was performed in only 7 cases (33.8%). Three of 9 patients with lymph node metastasis, and 7 of 8 patients without it reportedly survived. In the case of such a disease, a radical operation should be performed. If necessary post-operative therapy should also be given.

Key words
primary malignant lymphoma of the appendix, perforative appendicitis, right hemicolectomy with regional lymphnode excision

Reprint requests
Naoki Imai Department of Surgery, Yohroh Chuoh Hospital
986 Oshikoshi, Yohroh-cho, Yohroh-gun, Gifu, 503-13 JAPAN

Accepted
June 5, 1991

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