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Case Reports
. 2021 Jan 28;13(1):e12956.
doi: 10.7759/cureus.12956.

Ileo-Colonic Fistula Due to Diffuse Large B Cell Lymphoma: Unusual Presentation of a Rare Disease

Godson Senyondo  1 , Saif Bella  2 , Atif Saleem  2 , Sarah A Mehdi  3 , Jagmohan Sidhu  4
Affiliations
Case Reports

Ileo-Colonic Fistula Due to Diffuse Large B Cell Lymphoma: Unusual Presentation of a Rare Disease

Godson Senyondo et al. Cureus. .

Abstract

Malignant ileocolonic fistulas have seldom been documented as complications of a primary gastrointestinal lymphoma (PGIL) such as aggressive diffuse large B cell lymphoma (DLBCL). These fistulas are frequently misdiagnosed due to the nonspecific clinical presentation. Currently, there is no standardized treatment approach, although a couple have been suggested with varying outcomes. We describe a case of DLBCL complicated with a malignant ileocolonic fistula in a 55-year-old male with a favorable outcome after surgery and chemotherapy.

Keywords: malignant ileo-colonic fistula.; primary gastro intestinal lymphoma.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Unenhanced cross section CT scan of the abdomen showing an ileocolonic fistula with aneurysmal dilation of the small bowel (green arrow).
Figure 2
Figure 2. Endoscopic picture showing the fistula at 20cm from the anal verge (left) and a small bowel fistulizing mass (right).
Figure 3
Figure 3. H&E (left) and BCL6 (right) stained histology slides showing malignant high grade DLBCL cells (MYC and IGH/BCL2 negative but BCL6 positive) infiltrating the small bowel.
BCL6: B-cell lymphoma 6; H&E: hematoxylin and eosin; DLBCL: diffuse large B-cell lymphoma
See this image and copyright information in PMC

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