A 78-year-old male with a history of hypertension and double aortic valve lesion presented with a clinical history of meteorism and early post-pandrial plenishment.
On different occasions he had presented abdominal disfunction and absence of gases.
Physical examination was normal, with no palpable lymph nodes, masses or visceromegaly and good nutritional status.
Blood count and biochemistry were normal.
During the study, an opaque enema was performed, in which a blind contrast enhancement defect was observed.
The suspicion of neoplasia at this level was established by means of a fixation which confirmed the presence of an extensive mass in the cecal area, from which multiple biopsies were obtained.
The pathological report described a large B-cell lymphoma with high proliferative index.
The extension study by cervical-thoracic-abdominal CT and ultrasound showed no extracolonic lesions.
The medullogram performed was normal.
Serology for viruses, including HIV, was negative.
The surgical specimen contained a colon-blind segment of 25 cm in length and a terminal ileum segment of 6 cm. The tumor consisted of diffuse and circumferential thickening of the cecal wall measuring 1.5 cm in thickness.
Histological and immunohistochemical studies confirmed a large B-cell lymphoma with a high proliferative index.
Surgical margins, lymph nodes, omentum and a hepatic cylinder were free of disease.
One year later, the patient is asymptomatic and there is no evidence of recurrence.
