An unusual cause of colic stenosis in a renal transplant recipient: primary colonic diffuse large B-cell lymphoma

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COD: 2983_31_01_2019_EP Categorie: , ,

Niccolò Petrucciani, Tarek Debs, Giuseppe Nigri, Paolo Aurello, Francesco D’Angelo, Jean Gugenheim, Luciano Izzo, Federico Tomassini, Stefano Valabrega

Ann Ital Chir, Digital Edition 2019, 8
Epub, Jan. 31

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BACKGROUND: Primary colic lymphoma represents a rare disease accounting for the 0.2%-0.6% of all large-bowel malignancies.
We here report a case of diffuse large B-cell lymphoma presenting as a left colic stenosis in a patient who had
undergo renal transplant 23 years before.
CASE REPORT: A 67-years old man presented with recurrent abdominal pain, distension, nausea and constipation since 3
weeks. His past medical history included hepatic and renal polykystose with renal transplant 23 years before. Colonoscopy
revealed a non-surmountable inflammatory left colic stenosis at 55 cm from the anal verge. Biopsies demonstrated inflammatory
colic mucosa without neoplastic cells. Non-enhanced CT scan and CT virtual colonoscopy were performed, showing
a left colon circumferential thickening of 4 cm. Laparoscopic left colectomy was performed to treat the colic obstructive syndrome
and to have complete specimen analysis. After Pathological analysis and Immunohistochemistry the diagnosis of diffuse
large B cell lymphoma was established. The resection was R0. The postoperative course was uneventfully.
CONCLUSION: Large B-cell lymphoma represents a rare case of bowel tumor. However it has to be considered in the differential
diagnosis of colic stenosis in immunosuppressed patients as transplant recipients.

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