Burkitt-type lymphoma incidentally found as the cause of acute appendicitis: a case report and review of literature

Background Appendectomy remains one of the most common emergency operations. Recent research supports the treatment of uncomplicated appendicitis with antibiotics alone. While nonoperative management of appendicitis may be safe in some patients, it may result in missed neoplasms. We present a case of acute appendicitis where the final pathology resulted in a diagnosis of a Burkitt-type lymphoma. Case presentation An 18-year-old male presented to the emergency department with 24 h of right lower quadrant pain with associated urinary retention, anorexia, and malaise. Past medical history was significant for intermittent diarrhea and anal fissure. He exhibited focal right lower quadrant tenderness. Workup revealed leukocytosis and CT uncovered acute appendicitis with periappendiceal abscess and no appendicolith. Laparoscopic appendectomy was performed and found acute appendicitis with associated abscess abutting the rectum and bladder. Pathology of the resected appendix reported acute appendicitis with evidence of Burkitt-type lymphoma. A PET scan did not reveal any residual disease. Hematology/oncology was consulted and chemotherapy was initiated with an excellent response. Conclusions Appendiceal lymphomas constitute less than 0.1% of gastrointestinal lymphomas. Primary appendix neoplasms are found in 0.5–1.0% of appendectomy specimens following acute appendicitis. In this case, appendectomy allowed for prompt identification and treatment of an aggressive, rapidly fatal lymphoma resulting in complete remission.

Histopathological features and immunophenotyping of canine transmural gastrointestinal lymphoma using full-thickness biopsy samples

To elucidate the histopathological characteristics and immunophenotypes of canine transmural “mass-forming” gastrointestinal lymphomas and plasmacytomas, 83 surgically resected biopsy samples were examined. All lymphomas and plasmacytomas were located in the small or large intestine except for 1 plasmacytoma which was in the stomach. According to the World Health Organization (WHO) classification, B-cell neoplasms (17 cases) included lymphoplasmacytic lymphoma (6/17), plasmacytoma (5/17), follicular lymphoma (3/17), and diffuse large B-cell lymphoma (3/17). Based on nuclear sizes, T-cell neoplasms (66 cases) were broadly divided into large cell lymphoma (LCL; 48/66) and small cell lymphoma (SCL; 18/66). According to the WHO classification, T-cell neoplasms included anaplastic large T-cell lymphoma (ALCL; 10/66), angiotropic T-cell lymphoma (3/66), mixed inflammatory type peripheral T-cell lymphoma (mixed inflammatory type PTCL; 33/66), and PTCL-not otherwise specified (PTCL-NOS; 20/66). Mixed inflammatory type PTCLs were further divided into histiocyte- (27/33) and eosinophil- (6/33) dominant types. Immunohistochemically, lymphoplasmacytic lymphomas were positive for Pax5 (6/6) and IgM (5/6), while plasmacytomas were positive for IgG (5/6) and negative for Pax5. LCLs were immunopositive for granzyme B in 31/48 cases (65%) and CD8 in 9/48 cases (19%), while SCLs were immunopositive for granzyme B in 3/18 cases (17%) and CD8 in 3/18 cases (17%). Furthermore, 8/10 cases (80%) of ALCL and 19/27 cases (70%) of histiocyte-dominant PTCL were immunopositive for granzyme B, whereas 6/20 cases (30%) of PTCL-NOS, 1/6 cases (17%) of eosinophil-dominant PTCL, and no cases of angiotropic T-cell lymphomas were immunopositive for granzyme B. The present study describes the immunophenotypes in different histological types of transmural gastrointestinal lymphomas in the dog.

Mucosa-associated lymphoid tissue lymphoma of the appendix stump: a case report

Primary lymphomas of the appendix occur in 0.015% of all gastrointestinal lymphomas. The most common manifestation is acute appendicitis secondary to luminal obstruction. The most common is immunophenotype B low-grade non-Hodgkin lymphoma. A 53-year-old male, with a previous three-week surgical history due to acute appendicitis, histopathological report of acute appendicitis and lymphoid hyperplasia. Later, he was admitted, with abdominal pain in the right iliac fossa, an abdominal ultrasound and simple abdominal tomography were performed, with suspicion of residual abscess. Surgical intervention is decided, observing paracecal tumor in the emergency site of the appendix, the tumor is removed. Pathological study that reports an appendicular base infiltrated by mucosa-associated lymphoma. The diagnosis of appendicular tumors is mostly, intraoperatively incidental. It is necessary to have the diagnostic possibility when performing an appendectomy, since it changes the prognosis and treatment of the patient.

Clinicopathological study of gastrointestinal Lymphomas and their survival in the patients referred to Yazd hospitals during 2011 to 2016

Introdution: Malignant lymphoma is divided into two subgroups of Hodgkin's and non-Hodgkin's, and 40% of them occur in areas other than the lymph node, the most common being the digestive tract. According to studies, in recent years the prevalence of non-Hodgkin's lymphomas has increased over the past. Therefore, in this study, we investigated the gastrointestinal lymphoma and the survival rate of the patients with this disease based on clinicopathologic characteristics. Methods: This study was an analytic-cross sectional study. The study population included 97 patients with various types of gastrointestinal lymphoma referring to 3 hospitals in Yazd during 2011-2011. Sampling was done by census. Referring to pathology department of hospitals, all cases related to gastrointestinal tract lymphoma extracted and the information (age, sex, year of diagnosis, type of lymphoma, location of lymphoma, treatment method and survival rate) using the checklist was recorded. The data were analyzed by SPSS18 software and patients' survival was assessed using Kaplan-Meier curves and Log-Rank test. Results: The results of the study showed that out of 97 patients, 69 patients (71.1%) were male and 28 (28.9%) were female. The mean age of the patients was 49.28±21.5. The most common site of lymphoma was stomach (45.4%), the most common type of treatment, surgical+ chemotherapy (53.6%), and the most common type of lymphoma, B cell lymphoma (50%). The mean survival time was 48 months and there was a significant relationship between mean survival time according to type of treatment. Conclusion: According to the results, it can be concluded that the appropriate treatment for patients with gastrointestinal lymphomas is surgical+chemotherapy combination therapy.

Gastrointestinal lymphomas

Primary gastrointestinal lymphoma is the most common extranodal lymphoma and is almost exclusively of non-Hodgkin type. It is defined as lymphoma that has presented with the main bulk of disease in the gastrointestinal tract, with or without involvement of contiguous lymph nodes. MALT lymphoma is an indolent B-cell lymphoma whose histology recapitulates the features of mucosa-associated lymphoid tissue (MALT). It most commonly affects the stomach, presenting with nonspecific dyspepsia. Most cases appear to be driven by Helicobacter pylori, with 75% regressing following eradication of the organism with appropriate antibiotics. Deeply invasive lymphomas and those with adverse histological or cytogenetic features are unlikely to respond. Mantle cell lymphoma and follicular lymphoma are adult B-cell lymphomas that can present as gastrointestinal lymphomas. Diffuse large B-cell lymphoma is an aggressive lymphoma that is relatively frequently encountered in gastrointestinal locations. Burkitt’s lymphoma is also an aggressive B-cell lymphoma, and is the most frequent childhood gastrointestinal lymphoma. Enteropathy-associated T-cell lymphoma is an intestinal lymphoma of intraepithelial T lymphocytes that occurs most commonly in the jejunum or ileum and is associated with coeliac disease. It presents with abdominal pain, often due to intestinal perforation. The prognosis is usually poor, with death frequently resulting from abdominal complications in patients already weakened by uncontrolled malabsorption.