J Korean Surg Soc.  2001 Dec;61(6):625-628.

A Case of Primary Non-Hodgkin's Lymphoma Presented as Appendicitis

Affiliations
  • 1Department of General Surgery, Dongguk University College of Medicine, Gyongju, Korea. jgh@dumc.or.kr
  • 2Department of Internal Medicine, Dongguk University College of Medicine, Gyongju, Korea.

Abstract

Malignant lymphoma comprise 1~4% of the malignant neoplasms of the gastrointestinal tract (GIT), although primary lymphoma of the appendix is exceedingly rare. Primary non-Hodgkin's lymphoma (NHL) of the appendix reportedly represents 0.015% of all GIT lymphomas. Most cases of primary appendiceal lymphoma have presented with a clinical appearance of acute appendicitis. It is therefore difficult to diagnosis preoperatively. We report a case of primary NHL of the appendix in a 31 year-old female. Appendectomy was performed as a result of the clinical diagnosis of acute appendicitis, due to the rebound tenderness of McBurney's point and a thickend appendiceal wall seen on abdominal ultrasonography. Microscopic examination demonstrated an atypical large lymphoid cell dispersed in a background of small lymphocytes. There were no invading tumor cells on the resection margin. Immunohistochemical studies revealed the large atypical cells stained with B cell marker (CD20), Bcl-6, Ki-67 and UCHL-1 (CD45R0). The post-operative work- up consisted of a CT scan of the abdomen and thorax, a bone marrow biopsy and a gastrofiberscope. These results were normal. No further treatment was recommended. The patient is now 12 months post-operative and doing well.

Keyword

Appendix; Non-Hodgkin's lymphoma; Diffuse large B-cell lymphoma

MeSH Terms

Abdomen
Adult
Appendectomy
Appendicitis*
Appendix
Biopsy
Bone Marrow
Diagnosis
Female
Gastrointestinal Tract
Humans
Lymphocytes
Lymphoma
Lymphoma, Non-Hodgkin*
Thorax
Tomography, X-Ray Computed
Ultrasonography
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