RESUMEN
INTRODUCTION AND IMPORTANCE: Pneumatosis cystoides intestinalis (PCI) is an uncommon condition characterized by intramural gas accumulation in the intestinal submucosa. Idiopathic or secondary is presented with non-specific clinical signs; in some cases, diagnosis is incidental. Its acute presentation is uncommon, and surgical management could be performed in selected cases. CASE PRESENTATION: We present the case of an 85-year-old woman with 3 days of abdominal pain, 6 months of weight loss, and abdominal distension after meals. Abdominal computed tomography evidenced PCI at the small intestine with changes due to intestinal ischemia and internal mesenteric hernia. Intestinal resection and lateral-lateral mechanical anastomosis were performed with no complications after 90 days of follow-up. CLINICAL DISCUSSION: PCI is an infrequent and benign condition; pathophysiology is, to date, poorly understood. Idiopathic or secondary to other gastrointestinal pathologies are described. The final diagnosis is performed with histopathological analysis. Nevertheless, in some cases, the benign nature could be presented as an acute abdomen, and surgical management should be in the physician's armamentarium. CONCLUSION: PCI is an uncommon and benign entity. Nevertheless, in some cases, it could be presented as an acute abdomen. The surgical approach is appropriate, safe, and feasible.
RESUMEN
Natural killer/T cell lymphomas chiefly involving the midline facial structures including the nasal cavity or nasopharyns are a relatively rare type of non-Hodgkin's lymphoma. Apart from the upper respiratory tract, the disease occasionally presents in certain extranodal sites, such as the central nervous system, skin, gastrointestinal tract, or testes. We report a case of natural killer NK/T cell lymphoma as a testicular tumor in a 36-year-old man with a history of progressive swelling of his right testicle. Histologically, the testicular mass showed a diffuse infiltrate of medium-sized and atypical large lymphoid cells with angiocentric infiltration and areas of coagulative necrosis. Immunohistochemical studies demonstrated tumor cells staining positively with CD3, TIA-1, and Granzyme B. The Epstein-Barr virus genoma was detected by in situ hybridization. There were no abnormal findings in the nasal and nasopharyngeal regions. Classified as stage IEA, the patient received involved-field irradiation to contralateral testis (45 Gy), followed by systemic chemotherapy with a combination regimen ofL-asparaginase, methotrexate and dexamethasone. Relevant literature is reviewed, and the clinicopathologic features, natural history, and treatment options for primary testicular NK/T cell lymphoma are discussed.
RESUMEN
Natural killer/T cell lymphomas chiefly involving the midline facial structures including the nasal cavity or nasopharyns are a relatively rare type of non-Hodgkin's lymphoma. Apart from the upper respiratory tract, the disease occasionally presents in certain extranodal sites, such as the central nervous system, skin, gastrointestinal tract, or testes. We report a case of natural killer NK/T cell lymphoma as a testicular tumor in a 36-year-old man with a history of progressive swelling of his right testicle. Histologically, the testicular mass showed a diffuse infiltrate of medium-sized and atypical large lymphoid cells with angiocentric infiltration and areas of coagulative necrosis. Immunohistochemical studies demonstrated tumor cells staining positively with CD3, TIA-1, and Granzyme B. The Epstein-Barr virus genoma was detected by in situ hybridization. There were no abnormal findings in the nasal and nasopharyngeal regions. Classified as stage IEA, the patient received involved-field irradiation to contralateral testis (45 Gy), followed by systemic chemotherapy with a combination regimen ofL-asparaginase, methotrexate and dexamethasone. Relevant literature is reviewed, and the clinicopathologic features, natural history, and treatment options for primary testicular NK/T cell lymphoma are discussed.
