Subject(s)
Adenoma/pathology , Adenomatous Polyps/pathology , Colorectal Neoplasms/pathology , Precancerous Conditions/pathology , Adenoma/epidemiology , Adenoma/surgery , Adenomatous Polyps/epidemiology , Adenomatous Polyps/surgery , Adult , Age Distribution , Aged , Aged, 80 and over , Biopsy, Needle , Cohort Studies , Colectomy/methods , Colonic Polyps/epidemiology , Colonic Polyps/pathology , Colonic Polyps/surgery , Colorectal Neoplasms/epidemiology , Colorectal Neoplasms/surgery , Female , Humans , Immunohistochemistry , Incidence , Male , Middle Aged , Prognosis , Retrospective Studies , Risk Assessment , Sex Distribution , Survival Analysis , Treatment OutcomeABSTRACT
Low-grade lymphoma arising in mucosa-associated lymphoid tissue (MALT) of the duodenum represents a very rare neoplasm. We report an unusual presentation of primary duodenal MALT lymphoma in a 78-year-old man. The patient initially presented with a suspected pulmonary embolus and was anticoagulated, which precipitated a major gastrointestinal hemorrhage. A large atypical ulcer with narrowing of the duodenum beyond the bulb was seen on endoscopy. Biopsies revealed atypical lymphoid cells. Abdominal CT scan revealed a mass in either the duodenum or head of the pancreas. An endoscopic retrograde cholangiopancreatography (ERCP) was performed, which revealed a normal pancreatic duct with a large calculus in the common bile duct, which was extracted after sphincterotomy. Elective surgery was planned for suspected lymphoma of the duodenum. The patient developed severe nausea, vomiting, and fullness after meals. The patient underwent pancreaticoduodectomy for a neoplastic mass causing duodenal obstruction. Pathological examination of the resected specimen revealed a low-grade B-cell lymphoma (MALToma) arising in the duodenum and invading the pancreas. Flow cytometry confirmed the phenotype typical of MALT lymphoma. Celiac, peripancreatic, pelvic, and cervical nodes were also involved with tumor. Bone marrow was also positive for metastasis. The patient was postoperatively treated with chemotherapy for stage IV disease.
Subject(s)
Duodenal Neoplasms/complications , Duodenal Neoplasms/surgery , Gastric Outlet Obstruction/surgery , Lymphoma, B-Cell, Marginal Zone/complications , Lymphoma, B-Cell, Marginal Zone/surgery , Aged , Combined Modality Therapy , Duodenal Neoplasms/diagnosis , Duodenal Neoplasms/drug therapy , Gastric Outlet Obstruction/etiology , Humans , Lymphoma, B-Cell, Marginal Zone/diagnosis , Lymphoma, B-Cell, Marginal Zone/drug therapy , MaleABSTRACT
Página que contiene imágenes endoscópicas del esófago, estómago, duodeno, endoscopia capsular, enfermedades inflamatorias del intestino, etc. Cada imágen incluye una breve explicación.
Subject(s)
Endoscopy, Gastrointestinal , Esophagus , Stomach , Duodenum , Inflammatory Bowel Diseases , Colon , Ileum , Capsule EndoscopyABSTRACT
Somatostatinomas are extremely rare periampullary malignant neuroendocrine tumors that may be associated with von Recklinghausen disease or type-I neurofibromatosis. Duodenal somatostatinomas are distinguished from pancreatic somatostatinomas by their frequent association with type-I neurofibromatosis and typically absence of somatostatinoma syndrome. We report a very rare and atypical case of malignant duodenal somatostatinoma presenting with somatostatinoma syndrome in association with type-I neurofibromatosis.
