Primary gastrointestinal NHL accounts for 30–40% of all extranodal NHL. Primary gastrointestinal lymphomas constitute 5% of total gut neoplasms. Bowel perforation is a severe life-threatening complication and sometimes initial presentation of gastrointestinal lymphoma. A 60-year-old man presented with complaints of abdominal pain, distension, nausea and vomiting. There was clinical suspicion of acute intestinal perforation, which was confirmed by radiology. The patient underwent emergency laparotomy. The resected bowel on histopathological examination and immunohistochemistry was diagnosed as the high-grade transformation of follicular lymphoma (FL). The patient received 6 cycles of chemotherapy and is doing well at 3 years of follow-up. Herein, we report this rare malignancy of the small intestine. FL mostly presents as a nodal disease but also involves the extranodal sites. The most common site of primary gastrointestinal-follicular lymphoma (GI-FL) is the small intestine. The cellular and molecular characteristic of GI-FL is different from that of the nodal FL. Extranodal FL is usually localized, but the prognosis of transformed FL is low, and these are managed by surgery followed by chemotherapy. High clinical suspicion and extensive sampling of perforated bowel are essential to diagnose the high-grade transformation of FL.
Gastrointest Tumors

中文翻译：

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罕见小肠淋巴瘤的常见表现：罕见病例实体

原发性胃肠道 NHL 占所有结外 NHL 的 30-40%。原发性胃肠道淋巴瘤占肠道肿瘤总数的 5%。肠穿孔是一种严重的危及生命的并发症，有时是胃肠道淋巴瘤的初始表现。一名 60 岁男性主诉腹痛、腹胀、恶心和呕吐。临床怀疑急性肠穿孔，经放射学证实。患者接受了急诊剖腹手术。经组织病理学检查和免疫组化检查切除的肠被诊断为滤泡性淋巴瘤（FL）的高度转化。患者接受了 6 个周期的化疗，并且在 3 年的随访中表现良好。在此，我们报告了这种罕见的小肠恶性肿瘤。FL 主要表现为淋巴结疾病，但也涉及结外部位。原发性胃肠滤泡性淋巴瘤 (GI-FL) 最常见的部位是小肠。GI-FL 的细胞和分子特征与淋巴结 FL 不同。结外 FL 通常是局部的，但转化的 FL 的预后很低，这些都是通过手术和化疗来管理的。高度的临床怀疑和对穿孔肠的广泛取样对于诊断 FL 的高度转化至关重要。这些是通过手术和化疗来管理的。高度的临床怀疑和对穿孔肠的广泛取样对于诊断 FL 的高度转化至关重要。这些是通过手术和化疗来管理的。高度的临床怀疑和对穿孔肠的广泛取样对于诊断 FL 的高度转化至关重要。
胃肠道肿瘤