A CASE OF INTUSSUSCEPTED MALIGNANT LYMPHOMA OF THE ILEUM DIAGNOSED BY COLONOSCOPY PREOPERATIVELY

A 28-year-old man was seen at the hospital because of intermittent lower abdominal pain and abdominal distention. A fist-sized mass was palpated in the right lower abdomen. Barium enema study and abdominal ultrasonography showed a polypoid lesion intussuscepted into the cecum from terminal ileum. Colonoscopy revealed a polypoid lesion with erosion in the ascending colon. Biopsied specimens from the tumor was diagnosed as malignant lymphoma. We performed a right hemicolectomy. The tumor 6.5×7.5cm in size and 4.5cm in height was located in the terminal ileum. Histological study revealed the malignant lymphoma diffuse, large cell type (B cell type). Malignant lymphoma of the ileum sometimes causes intussusception. It often demands emergency operation due to intestinal obstruction or anal bleeding, and hence it is hard to make the definite diagnosis preoperatively. For making the definite diagnosis, colonoscopic biopsy is useful. Aggressive colonoscopic observation and precise biopsy of the tumor should make the preoperative correct diagnosis possible.