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Non-Hodgkin Lymphoma of the jejunum presenting as perforation peritonitis: A case report.

ABSTRACT: Primary gastrointestinal lymphoma is very rare compared to gastrointestinal tract lymphoma arising from secondary to primary nodal disease. Extra nodal lymphoma can involve any part of the gastrointestinal tract, most commonly being the stomach followed by small intestine and ileocecal region. They are indistinguishable from other benign and malignant conditions and are clinically non-specific. While perforation is common among patients undergoing lymphoma treatment, presentation of primary gastrointestinal lymphoma as perforation is rare and needs proper evaluation and management. Here, we describe an interesting case in which a patient presenting with peritonitis was found to have perforation and mass of the jejunum. Resection and anastomosis were performed as intervention, with subsequent histopathological examination showing Malignant Non-Hodgkin lymphoma (NHL). Postoperative follow up was provided along with the appropriate chemotherapy regimen.

SUBMITTER: Warsinggih

PROVIDER: S-EPMC7251296 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Non-Hodgkin Lymphoma of the jejunum presenting as perforation peritonitis: A case report.

Warsinggih Darmadi Suluh S Prihantono Faruk Muhammad M

Annals of medicine and surgery (2012) 20200518

Primary gastrointestinal lymphoma is very rare compared to gastrointestinal tract lymphoma arising from secondary to primary nodal disease. Extra nodal lymphoma can involve any part of the gastrointestinal tract, most commonly being the stomach followed by small intestine and ileocecal region. They are indistinguishable from other benign and malignant conditions and are clinically non-specific. While perforation is common among patients undergoing lymphoma treatment, presentation of primary gast ...[more]

PMID: 32477511

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Project description:IntroductionParaneoplastic pruritus is defined as pruritus that occurs before or during the natural evolution of a hematologic disease. The reported prevalence is 30% in patients with Hodgkin's lymphoma. The severity of this pruritus has a very negative impact on patients' quality of life. Very few studies have been made to examine the efficacy of pharmacological treatments for this type of pruritus. One drug that appears to be effective in this respect is off-label aprepitant, a neurokinin 1 receptor antagonist.Case presentationA 20-year-old Caucasian woman presented with lateral neck nodes, sweating, and pruritus and was diagnosed with stage IIB nodular sclerosis Hodgkin's lymphoma. Throughout this period during the disease the pruritus was ever-present. Improvement was achieved with some of the chemotherapy treatments, but the symptom returned when the various treatments were withdrawn due to disease progression or poor tolerance. In the middle of the seventh year, she was admitted to our hospital with uncontrolled pruritus that resulted in severe lesions due to scratching. In response, aprepitant (off-label) 80 mg/day was added to the chemotherapic treatment of the pruritus, after studying the various treatment options. She reported a score of 9 on a visual analogue scale for the pruritus, and a score of 3 on the Eastern Cooperative Oncology Group performance status scale of performance status. After two weeks of treatment with aprepitant, she reported a score of 5 on the visual analogue scale for the pruritus, and this improved to a score of 4 in a month, which allowed her to lead a better quality of life, with an Eastern Cooperative Oncology Group performance status score between 1 and 2.ConclusionsSeveral cases and case series have been reported on the use of aprepitant for paraneoplastic pruritus, but none have referred to its use for Hodgkin's lymphoma. A prospective study was carried out to evaluate the efficacy of this drug in refractory pruritus secondary to Sezary syndrome, and other authors have studied the effectiveness of aprepitant against pruritus, secondary to biological therapy with erlotinib. In our case report, treatment was started with daily doses of aprepitant 80 mg. Pruritus improvement appeared to be attributable exclusively to the administration of aprepitant.

Dataset Information

Non-Hodgkin Lymphoma of the jejunum presenting as perforation peritonitis: A case report.

Publications

Non-Hodgkin Lymphoma of the jejunum presenting as perforation peritonitis: A case report.

Similar Datasets

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