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Diffuse large B-cell lymphoma of the colon

Case contributed by Mohammad Taghi Niknejad
Diagnosis almost certain

Presentation

Abdominal pain and chronic constipation.

Patient Data

Age: 65 years
Gender: Male

A 155×95×115 mm large heterogeneously enhancing mass is present at sigmoid colon accompanied by surrounding fat stranding and infiltrates left ureter as well as iliopsoas muscle. A few small regional lymphadenopathies are also observed. In addition, right sided ileostomy is evident. 

The hepatic attenuation value is less than of the spleen, suggesting fatty liver disease. 

A 48 mm simple cortical cyst is present at upper pole of right kidney. Mild to moderate hydroureteronephrosis is present at left side due to ureteral involvement. 

The prostate gland is enlarged.
 

Case Discussion

Pathology proven diffuse large B-cell lymphoma of the colon which is a very rare tumor, accounting for <0.5% of primary colorectal malignancies, ~1.5% of all lymphomas, and ~15% of gastrointestinal lymphoma.

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