Primary multilobated B-cell lymphoma of the small intestine. A case report.

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  • 小腸原発ｍｕｌｔｉｌｏｂａｔｅｄ　Ｂ細胞性リンパ腫の１例

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Abstract

We herein describe a rare case of primary multilobated B -cell lymphoma of the small intestine.<BR>A 43-year old Japanese man presented to our hospital because of nausea, vomiting and abdominal distension. Intraoperative exploration of the gastrointestinal tract showed two tumor lesions in the small intestine: one in the jejunum directly invading the transverse colon; the other in the ileum. The patient underwent left-sided colectomy and partial resection of the small intestine.<BR>The imprint materials obtained from the jejunal tumor showed an abundance of isolated tumor cells consisting of medium to large-sized atypical lymphocytes. The tumor cells showed clumping of nuclear chromatin and relatively abundant cytoplasms. The tumor cells had characteristic nuclear shapes which were recognizable three dimensionally as follows: 1) rough consecutive curvature appearing as twisted short sticks, 2) a certain point at which nuclear indentation concentrated in the nucleus itself, creating the appearance of a flower in bloom, 3) nuclear multilobulations similar to those of neutrophils. Approximately 26% of the tumor cells in the imprint materials had nuclear multilobulation, i.e., three to six lobules. Based on histological examination of the surgical materials including immunohistochemical analysis, we finally confirmed this case as belonging to the category of multilobated B-cell lymphoma.<BR>On imprint cytology of the lymphoma, we assumed that the presence of lymphoma cells possessing abundant cytoplasms and characteristic nuclear shapes such as those described above was suggestive of multilobated B-cell lymphoma.

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