A case of iatrogenic immunodeficiency-associated colonic lymphoma complicating ulcerative colitis
A case of iatrogenic immunodeficiency-associated colonic lymphoma complicating ulcerative colitis
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DOI：
10.1186/s13000-020-00954-8
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发表时间：
2020-04-07
影响因子：
2.6
通讯作者：
Yamakawa, Mitsunori
中科院分区：
文献类型：
--
作者：
Suzuki, Kazushi;Ohe, Rintaro;Yamakawa, Mitsunori
背景溃疡性结肠炎（UC）是炎症性肠病的主要类型之一，与淋巴组织增生性疾病和淋巴瘤的发病风险显著增加有关，其中大多数病例与长期使用免疫抑制剂有关。在这里，我们展示了一个非常罕见的情况下，其他医源性免疫缺陷相关的结肠弥漫性大B细胞淋巴瘤（Oii-DLBCL）并发UC和直肠穿孔。此外，我们回顾了以往的DLBCL与UC相关的病例的临床病理特征。病例介绍一名68岁男性在26个月前被诊断为左侧UC。尽管随后他接受了硫唑嘌呤和英夫利西单抗的免疫抑制治疗，但由于直肠穿孔，他接受了紧急全直肠结肠切除术。切除的标本表现出不规则的壁增厚和升高的多结节病变，从横结肠中段延伸到直肠，长度可达52 cm。组织学诊断为Oii-DLBCL，并保留由混合炎性细胞包围的隐窝脓肿。结论Oii-DLBCL合并UC并直肠穿孔极为罕见。肉眼和显微镜检查对早期诊断具有重要意义。
Background Ulcerative colitis (UC) is one of the major types of inflammatory bowel diseases and is associated with a significantly increased risk of not only lymphoproliferative disorders but also lymphomas, of which most cases are related to the long-term usage of immunosuppressants. Here, we demonstrate a very rare case of other iatrogenic immunodeficiency-associated colonic diffuse large B-cell lymphoma (Oii-DLBCL) complicating UC and rectal perforation. In addition, we reviewed the clinicopathological features of previous cases of DLBCL related to UC. Case presentation A 68-year-old man was diagnosed with left-sided UC 26 months prior. Although he was followed by immunosuppressive therapy with azathioprine and infliximab, an emergency total proctocolectomy was performed due to rectal perforation. The resected specimen exhibited irregular wall thickening and elevated multinodular lesions extending from the mid-transverse colon to the rectum, measuring up to 52 cm in length. Histologically, the lesion was diagnosed as Oii-DLBCL and crypt abscess surrounded by mixed inflammatory cell was remained. Conclusion Oii-DLBCL complicating UC with rectal perforation is extremely rare. Macro- and microscopic findings are important for early diagnosis of the lesion.