A Case of the Malignant Lymphoma of the Duodenum Accompanied with Obstructive Jaundice

Gen Sugawara, Susumu Fujioka, Kenji Katoh, Yuuichi Machiki, Hitosi Tomono, Kiyosi Aikawa, Mizuo Hashimoto, Yukihiro Yokoyama, Akira Ishikawa and Katsue Yoshida^*

Department of Surgery and Department of Pathology^*, Kiryuu Kohsei General Hospital

We report a case of malignant lymphoma of the duodenum accompanied with obstructive jaundice. A 76-year-old woman was admitted to our hospital with complaints of back pain and jaundice. On endoscopic examination, a giant irregular elevated lesion lesion accompanied by ulceration was found from the duodenal bulb to the 2nd portion of the duodenum. Histological examination of a biopsy specimen revealed non Hodgkin's lymphoma. Complete obstruction of the common bile duct (CBD) was observed by percutaneus transhepatic cholangiography. Computed tomography revealed a thickened wall of the duodenal bulb, with no evidence of distant metastasis. Pancreaticoduodenectomy was carried out. The size of the tumor was 9×5 cm. Pathological examination demonstrated non Hodgkin's lymphoma (B cell type), medium sized cell type. The tumor invaded the CBD and the pancreatic head. Regional lymph nodes were also involved. She received chemotherapy (vincristine, cyclophosphamide, mercaptopurine, prednisolone), and was discharged 81 days after the operation. There are 72 reports regarding malignant lymphoma of the duodenum in Japan.

Key words
malignant lymphoma of the duodenum, obstructive jaundice

Reprint requests
Gen Sugawara Department of Surgery, Ogaki Municipal Hospital 4-86 Minaninokawa-machi, Ogaki, 503-8502 JAPAN

Accepted
December 9, 1998

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