Rare malignant ulcer related to primary intestinal diffuse large B-cell lymphoma: A case report

Medicine (Baltimore). 2020 Feb;99(6):e18590. doi: 10.1097/MD.0000000000018590.

Abstract

Rationale: The specific pathogenesis of the diffuse large B-cell lymphoma(DLBCL)is still indefinite and argumentative. It is known that DLBCL is the most common type of non-Hodgkin's lymphomas (NHL). A lot of cases of DLBCL such as primary gastric diffuse large B-cell lymphoma(PG-DLBCL) are reported. However, primary intestinal diffuse large B-cell lymphoma(PI-DLBCL) is unusual.

Patient concerns: We present a case of a 57-year-old male diagnosed in the Gastroenterology Department, which presented a bleeding duodenal ulcer with irregular borders.

Diagnoses: The immunohistochemical staining showed: CD20(+++), CD10(+) and Ki-67>40%.

Interventions: The patient was successfully treated by Poly-chemotherapy with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vindesine and prednisolone).

Outcomes: After 6 courses of chemotherapy treatment, the duodenal ulcer was completely healed by reviewing the UGIE.

Lessons: Our report might give further strength to avoiding the erroneous and missed diagnosis for PI-DLBCL which is different from common duodenal ulcer.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Cyclophosphamide / therapeutic use
  • Diagnosis, Differential
  • Doxorubicin / therapeutic use
  • Duodenal Ulcer / etiology*
  • Humans
  • Immunohistochemistry
  • Intestinal Neoplasms / complications
  • Intestinal Neoplasms / diagnosis*
  • Intestinal Neoplasms / diagnostic imaging
  • Intestinal Neoplasms / drug therapy
  • Lymphoma, Large B-Cell, Diffuse / complications
  • Lymphoma, Large B-Cell, Diffuse / diagnosis*
  • Lymphoma, Large B-Cell, Diffuse / diagnostic imaging
  • Lymphoma, Large B-Cell, Diffuse / drug therapy
  • Male
  • Middle Aged
  • Prednisone / therapeutic use
  • Rituximab / therapeutic use
  • Vincristine / therapeutic use

Substances

  • R-CHOP protocol
  • Rituximab
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone