Adult Intussusception Due to Mucosa-Associated Lymphoid Tissue Lymphoma of Terminal Ileum: Report of a Case

發生在終端迴腸之粘膜相關淋巴組織淋巴瘤導致成人腸套疊：病例報告

陳青富(Ching-Fu Chen) ； 許自齊(Tzu-Chi Hsu) ； 林錫泉(Shee-Chan Lin) ； 施壽全(Shou-Chuan Shih) ； 楊斐適(Fee-Shih Yang) ； 曾嶔元(Chin-Yuan Tzen)

《Formosan Journal of Surgery》 37卷5期 (2004/10) Pp. 225-229

https://doi.org/10.29833/FJS.200410.0005

摘要

腸套疊很少發生在成人。成人腸套疊的發生，主要是因為腸道的腫瘤或是手術後遺症所造成。我們提出一個發生在終端迴腸之粘膜相關淋巴組織淋巴瘤導致成人腸套疊的罕見病例。一位八十一歲男性病患，主訴噁心、嘔吐和腹脹痛三天。腹部X光影像檢查發現小腸擴張而有阻塞像，腹部電腦斷層檢查顯示有一個標的樣腫瘤在近端升結腸而大腸內視鏡檢查也發現在近端升結腸有一個表面發赤的腫瘤，因此診斷為腸套疊導致小腸阻塞。剖腹手術中發現有一個3×3×2.5公分大小的腫瘤在終端迴腸作為引導點造成終端迴腸套疊入近端升結腸，而進行根除性右半側結腸切除手術併迴結腸吻合以及淋巴結切除。該腫瘤經組織病理診斷為枯膜相關淋巴組織淋巴瘤併局部淋巴結轉移。雖然發生在終端迥腸的粘膜相關淋巴組織淋巴瘤很罕見，在造成成人腸套疊的諸多病因中也必須考慮到它的可能性。

並列摘要

Intussusception is rare in adults, usually resulting from surgery or a neoplasm of the bowel. We describe a very rare case of adult intussusception due to mucosaassociated lymphoid tissue (MALT) lymphoma of the terminal ileum. An 81-year-old male was admitted with the chief complaints of nausea, vomiting, and abdominal pain and fullness for 3 days. Plain abdominal radiography showed multiple dilated intestinal loops indicating a small bowel obstruction. Abdominal computed tomography revealed a target mass in the proximal ascending colon, and colonoscopy showed a protruding tumor with erythematous mucosa in the proximal ascending colon, indicating intussusception. A laparotomy revealed a 3×3×2.5 cm polypoid tumor as the lead point of a segment of the terminal ileum telescoped into the lumen of the proximal ascending colon causing an ileocolic intussusception. Radical right hemicolectomy as a standard resection for malignancy was performed. The pathologic diagnosis was MALT lymphoma with metastasis to a regional lymph node. Although MALT lymphoma of the terminal ileum is rare, it should be considered among the lesions capable of causing adult intussusception.

並列關鍵字

intussusception ； mucosa-associated lymphoid tissue ； lymphoma ； ileum