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首页> 外文期刊>The Open Pathology Journal >Primary Jejunal Diffuse Large B-Cell Lymphoma with Multiple SkipUlcers and Perforation Mimicking Crohn's Disease
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Primary Jejunal Diffuse Large B-Cell Lymphoma with Multiple SkipUlcers and Perforation Mimicking Crohn's Disease

机译：原发性空肠弥漫性大B细胞淋巴瘤，具有多个跳过器和模拟克罗恩病的穿孔

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Most primary intestinal lymphomas are single exophytic or annular tumor masses with diffuse large B-celllymphoma (DLBCL) as the most common histological type. Crohn's disease is a chronic inflammatory bowel diseasewith multiple skip ulcers. Here we reported the case of an elderly male presented with hollow organ perforation.Segmental resection of the jejunum revealed 5 skip ulcers, grossly mimicking Crohn’s disease. Pathological examinationrevealed diffuse sheets of large neoplastic cells expressing CD20, bcl-2, bcl-6 and MUM1 but not CD3 or CD10, aDLBCL of nongerminal center B-cell phenotype. In situ hybridization for Epstein-Barr virus was negative. Locus-specificinterphase fluorescence in situ hybridization assay showed negative results for chromosomal aberrations at the IGH,BCL2, BCL6 and MYC loci. The clinical staging was IE and the patient received rituximab and combinationchemotherapy. He was in complete remission for 14 months but unfortunately succumbed to an unidentified centralnervous system infection 4 months later without evidence of tumor recurrence. Although multiple skip ulcers mimickedCrohn's disease, they were transverse in direction as opposed to the usual longitudinal ulcers in Crohn's disease. Thecorrect diagnosis was reached by careful histopathological examination and ancillary studies.
机译：大多数原发性肠淋巴瘤是单个外生性或环状肿瘤块，弥漫性大B细胞淋巴瘤（DLBCL）是最常见的组织学类型。克罗恩氏病是一种慢性炎症性肠病，伴多发性溃疡。在这里，我们报道了一位老年男性患者出现中空器官穿孔的情况。空肠段切除术显示有5个跳跃性溃疡，完全模仿了克罗恩氏病。病理检查揭示了表达非生殖中心B细胞表型的CD20，bcl-2，bcl-6和MUM1但不表达CD3或CD10，aDLBCL的大肿瘤细胞的弥漫性表层。爱泼斯坦-巴尔病毒的原位杂交为阴性。基因座特异性相间荧光原位杂交检测显示在IGH，BCL2，BCL6和MYC基因座处的染色体畸变阴性结果。临床分期为IE，患者接受了利妥昔单抗和联合化疗。他已完全缓解了14个月，但不幸的是，在4个月后死于未确认的中枢神经系统感染，而没有肿瘤复发的迹象。尽管多个跳跃性溃疡模仿了克罗恩氏病，但它们在方向上是横向的，与克罗恩氏病中常见的纵向溃疡相反。通过仔细的组织病理学检查和辅助研究可以得出正确的诊断。

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