Gastro-Splenic Fistula Related to Large B Cell Lymphoma (original) (raw)
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Gastrosplenic fistula due to splenic lymphoma: Two case reports and literature Review
Background: Gastrosplenic fistula (GSF) is a rare and potentially fatal complication of various diseases. Lymphoma is the most common cause. It can occur spontaneously or after chemotherapy. This rare entity may be misdiagnosed. Treatment modalities include surgical resection, chemotherapy or a combination of both. Actually, more and more are headed towards a chemotherapy regimen only to treat GSF.Case presentation: Here we report two cases of GSF due to diffuse large B cell lymphoma patients. First case is of a 54-year-old woman with a primary enormous spleen diffuse large B cell lymphoma (DLBCL) leading to a spontaneous fistula in the stomach. The second one is of a 48 year-old-male patient with a primary spleen DLBCL which fistula complicating chemotherapy. The evolution was fatal for both of them after undergoing surgeryConclusions: GSF complicating lymphomas is a rare disease entity, our case report and a systematic review of the literature may help physicians to diagnose and t...
Spontaneous gastrosplenic fistula secondary to primary splenic lymphoma
Case Reports, 2010
A gastrosplenic fistula is a rare complication of gastric and splenic lymphomas which can occur spontaneously or secondary to chemotherapy. We report a case of a spontaneous gastrosplenic fistula secondary to a diffuse splenic large B cell lymphoma in a previously well 43-year-old patient. CT imaging demonstrated the fistula, which was subsequently managed with chemotherapy. The clinical management of this rare condition is discussed with a review of the literature.
Medical Journal of Trakya University, 2009
A fi stulous tract between the stomach and the spleen is a rare manifestation. Spontaneous gastrosplenic fi stula formation resulting from primary gastric lymphoma is extremely rare and should be managed as an emergency. To date, four gastrosplenic fi stulas originating from gastric lymphoma have been reported, of which three were spontaneous and one occurred following chemotherapy. We report a case of spontaneous gastrosplenic fi stula in a 35 years-old-man with gastric malignant B-cell non-Hodgkin's lymphoma who was diagnosed by computed tomography and endoscopically, followed by successful treatment with total gastrectomy and splenectomy.
An Atypical Case of Primary Gastric Lymphoma
Scholars Journal of Medical Case Reports, 2016
We report a case of a fifty-two-year old gentleman who presented with a history of early satiety after meals altered bowel habits for 1 month and fever for 2 weeks. On local examination, an intra-abdominal, non-tender, variegated swelling was found extending from left hypochondrium to the epigastric region. Contrast enhanced CT scan showed a heterogeneous mass (11 cm x 11 cm) at left upper quadrant, medial to spleen, compressing the stomach, ?Neoplastic lesion. Exploratory laparotomy found a huge irregular mass involving spleen, tail of pancreas, gerota's fascia and greater curvature of stomach, having adhesion with diaphragm and omentum, but without any enlarged lymph nodes. En-bloc excision of mass along with spleen, tail of pancreas, and a sleeve of stomach including the greater curvature was preformed. Subsequently, histopathology and immunohistochemistry confirmed it to be a case of Diffuse Large B-Cell Lymphoma of stomach (DLBCL).The rarity of the diagnosis along with its nature of presentation, and absence of several characteristic features make this case an interesting one.
Gastrosplenic fistula following successful chemotherapy for disseminated histiocytic lymphoma
Cancer, 1983
A case is presented of a patient with diffuse histiocytic lymphoma with splenic involvement who developed a communication between the greater gastric curvature and the splenic parenchyma after successful antineoplastic chemotherapy. This fistula was diagnosed by CT scan and confirmed by upper gastrointestinal barium series and fiberoptic endoscopy. This complication was managed successfully by an enbloc resection of the greater curvature of the stomach, splenectomy, and distal pancreatectomy. Histologic assessment of the stomach and spleen failed to reveal residual tumor. The clinical evolution of this rare complication is discussed and the literature on this subject is reviewed. Cancer 52:994-996. 1983. IRECT COMMUNICATION between two abdominal D viscera is usually the result of congenital, traumatic, inflammatory, neoplastic or iatrogenic processes' affecting one or both organs. Fistula formation is a rare complication of primary and secondary lymphomas of the gastrointestinal t r a~t ,~.~ although it is apparent that secondary involvement of intraabdominal viscera leads to a higher incidence of fistula f~r m a t i o n .~.~ Among the different histologic types, histiocytic lymphoma appears to have a greater propensity to produce perforation or fistula f~r m a t i o n .~.~ Although spontaneous fistualization may occur, the successful treatment of lymphoma by radiation the rap^,^ ~hemotherapy~,~ or has led to the development of this unusual complication. We report a case of diffuse histiocytic lymphoma with splenic involvement complicated by a fistulous tract between the stomach and the spleen during effective chemotherapy and successful surgery. This interesting course of events has not been reported previously.
Saudi medical journal, 2007
A gastrosplenic fistula is a rare complication of a gastric or splenic lesion. We report a case of Hodgkin's lymphoma nodular sclerosis involving the spleen that was complicated by spontaneous gastrosplenic fistula. The fistula was closed laparoscopically, and the patient underwent partial gastrectomy and gastric wall repair, followed by successful chemotherapy. This is also the first reported case in published literature where closure of gastrosplenic fistula and partial gastrectomy was carried out laparoscopically. We recommend that extensive open surgical procedures including total gastrectomy, splenectomy, and pancreatectomy may be avoided in the management of gastrosplenic fistula, and the patient could be managed by less radical, simple laparoscopic fistulectomy, with partial gastric resection. If the fistula is caused by a malignant process, the surgical repair should be followed by definitive treatment with chemotherapy and radiotherapy.
Primary Gastric Lymphoma (Diffuse Large B Cell Type)
2021
The most frequent extra-nodal site of lymphoma is gastric lymphoma. The bulk of such lesions are extra nodal marginal zone B mucosal cell lymphoma correlated with lymphoid tissue (MALT) type or diffuse lymphoma of large B cells. We are reporting a case of diffuse major B-Cellular gastric lymphoma, which at first showed indigestion, abdominal heaviness, nausea and widespread weakness with 3-4 months of weight loss. In the antropyloric region and distal portion of lesser curvature of stomach suggestive of aetiology of cancer, the CT abdomen shows circumferential wall thickening. DLBCL has been confirmed by HPE and IHC. The neoplasm entered serosa and was found to have adherence to the pancreatic capsule in stage IIE of gastric lymphoma. Following the staging, treatment with an R-CHOP regimen (rituximab, cyclophosphamide, oncovin (vincristine), hydroxydaunorubicin, and prednisone) was done.
Primary Pancreatic Lymphoma Presenting as Gastric Fistula: A Case Report
Non Hodgkin lymphoma primarily originating from the pancreas is a rare condition. Usual presentations include abdominal pain, anorexia and weight loss. Rarely, it may present as acute pancreatitis. Differentiating from the adenocarcinoma is difficult due to similar presentation and imaging features. Histopathological diagnosis is essential considering the impact on the management and prognostication. Presentation as fistulous communication with stomach or colon has not been reported in the literature. Here, we report a 73-year-male with primary pancreatic lymphoma presenting with gastric fistula.