A 74-year-old male with a history of ischemic heart disease treated with beta-blockers, isosorbed mononitrate, contraceptives and proton pump inhibitors.
She was referred to the gastroenterology service for a 9-month history of intense asthenia, anorexia and progressive increase in sweating, with weight loss of 15 kg, associated with diffuse abdominal pain and dysuria.
Analytically iron deficiency anemia was observed.
Diagnostic tests with sedation are requested.
A terminal ileocautery is performed, appreciating from rectum to cecum infinity of sessile lesions of polypoid appearance of 3-6 mm, more frequent in number in right colon and affecting ileocecal valve
The pathology of biopsies at different levels was nonspecific colitis with lymphoid follicular hyperplasia and eosinophilic infiltrate, which reached 60% of inflammatory cells.
After the results obtained and due to the progressive clinical worsening of the patient, it was decided to perform gastroscopy and repeat it for a new biopsy.
Multiple polypoid lesions of different sizes have been observed. Disturbed polypoid lesions have been described (8-9 mm) in the duodenal and gastric mucosa. These lesions have been previously eroded as well as in the distal vascularization.
The histopathological result of the gastric, duodenal and colon biopsies was dense diffuse lymphoid infiltrate in the mucosa and submucosa with glandular destruction and lymphoepithelial lesion all positive for CD1, with small size lymphocytes and small bowel habit Ki2 67 with colitis
The endoscopic findings confirm the diagnosis of stage IVB mantle non-Hodgkin lymphoma with gastric and small and large intestine involvement.
