AN INTERESTING CASE OF ILEAL MASS(NON-HODGKINS LYMPHOMA OF ILEUM)

Abstract

AN INTERESTING CASE OF ILEAL
MASS(NON-HODGKINS LYMPHOMA
OF ILEUM)Report Of A Case And Review
Of The Literature Non - Hodgkins
Lymphoma is a proliferation of discrete
masses with in Lymphnodes, Spleen or
Extranodal tissues apart from Hodgkins
Lymphoma which has its clinical and histological
distinction. Gastrointestinal tract
is the commonest extranodal site for
Lymphoma. Diagnostic criteria for primary
gastrointestinal lymphoma includes
absence of Superficial lymphadenopathy
on physical examination, absence of Mediastinal
lymphadenopathy on chest imaging,
Normal peripheral blood counts,
.A 36 years old male patient presented
with complaints of pain in the right lower
abdomen for 3 days duration with history
of vomiting and fever. On examination
patient was afebrile, tachycardia was
present. There was no generalized lymphadenopathy,
per abdominal examination
there was tenderness in the
right iliac fossa, maximum tenderness in
the Mc Burneys point with localised guarding
and rebound tenderness, no mass palpable,
Bowel sounds were sluggish. Provisional
clinical diagnosis was Acute Appendicitis.
On Ultrasonagraphy of the abdomen
an irregular hypoechoic lesion measuring
6.3 x 4.3 x 5.4 cm with air pockets was
seen with features suggestive of Appendicular
Abscess. Emergency Exploratory
Laparotomy was done, intra operatively an
inflammatory mass measuring 8 x 6 cm
was found around 10 cm proximal to the
Ileocaecal Junction in the distal Ileum with
Omental adhesions. Hence Ileal mass Resection
Anastomosis was done. Post operative
period was uneventful. Histopathological
examination proved to be high
grade NON-HODGKINS LYMPHOMA.
ConclusionPrimary Gastrointestinal
Non-Hodgkins Lymphoma is a rare
condition. Incidence of Primary Ileal Lymphoma
is 3 of all lymphomas. These patients
can rarely present with intestinal perforation,
bleeding and obstruction.