A Case of Malignant Lymphoma of the Mesentery with Intussuception.

Koji Fujita, Shinji Murai, Akihiko Nakamura and Motohide Shimazu^*

Department of Surgery, Ogikubo Hospital
^*Department of Surgery, Keio University School of Medicine

We report a case of malignant lymphoma of the mesentery with intussusception, a disorder that generally has a poor prognosis. A 56-year-old man admitted for abdominal discomfort was found in colonoscopy to have a submucosal tumor of the cecum with a red, sharp margin. Abdominal computed tomography (CT) showed a large 10×10 cm isodensity tumor in size located in the left upper abdomen and a smaller 4×3 cm tumor demonstrating intussusception in the right lower abdomen. The same region showed significant radioisotope uptake on Ga scintigraphy. The case was diagnosed as malignant lymphoma of the mesentery with intussusception. Surgical intervention consisted of partical resection of the jejunum for the main tumor and ileocecal resection of the terminal ileum for the submucosal tumor. Complete resection was not possible due to residual tumors near Treiz's ligament. Histopathological diagnosis was B-cell follicular lymphoma. Complete remission was achieved with 11 cycles of CHOP adjuvant chemotherapy. Tumor recurrence was detected 20 months after initial surgery, however, and second-line chemotherapy based on the VeMP protocol was administered. The patient is currently alive 22 months following surgery, and it is considered that he better survival.

Key words
malignant lymphoma, mesenterium, intussusception

Reprint requests
Koji Fujita Department of Surgery, Ogikubo Hospital 3-1-24 Imagawa, Suginami-ku, Tokyo 167-0035 JAPAN

Accepted
September 25, 2002

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