A Case of Primary Malignant Lymphoma of the Appendix

Atsuyuki Maeda, Akihiro Yamaguchi, Masatoshi Isogai, Akihiro Hori, Yukoh Kin, Manabu Takano, Masami Kawai, Ryuzo Yamaguchi, Tatsuharu Yamada, Tomoyuki Kubota

Department of Surgery, Ogaki Municipal Hospital

A rare case of primary malignant lymphoma of the appendix is reported, together with a review of 20 cases in the Japanese literautre. A 64-year-old man complaining of right lower quadrant abdominal pain underwent surgery under a preoperative diagnosis of appendiceal abscess. An enlarged, white, hard appendix was encountered, and a hard mass in the ileocecal mesentery was also palpated. Right hemicolectomy with lympohnode dissection was performed. Postoperative histological examination revealed a primary malignant lymphoma of the appendix which was to non-Hodgikin's lymphoma, diffuse large cell type according to the LSG classification. Adjuvant chemotherapy was added but he died of lymphnode recurrence one year and eleven months after the operation. Primary malignant lymphoma of the appendix is an extremely rare disease, and only 20 cases have been reported in the Japanese literature. Most of the cases were first diagnosed as having acute appendicitis, and appendectomy was performed. The definite diagnosis was obtained by postoperative histological examination. Extensive excision with regional lymphnode dissection should be performed in the case of this disease, and if necessary, postoperative therapy should also be added. However the prognosis is generally poor.

Key words
primary malignant lymphoma of the appendix, surgical resection

Reprint requests
Atsuyuki Maeda Department of Surgery, Ogaki Municipal Hospital
4-86 Minaminokawa,Ogaki-shi, 503 JAPAN

Accepted
January 11, 1995

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