case_images: PMC4729516_01
case_images: Plain abdominal radiographs taken in the emergency room 3 days before visiting the outpatient clinic showed mild to moderate ileus without definite mechanical obstruction. (A) Erect view. (B) Supine view.
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case_images: F1
case_images: After simple abdominal radiographs showed mild ileus in the lower abdomen (Fig. 1), an evacuation enema relieved her symptoms, with the expulsion of feces and gas.
case_images: Abdominal ultrasonography of the right upper abdomen. (A) An ileocolic-type intussusception was found with a crescent-shaped hypoechoic portion (arrows). (B) Enlarged lymph nodes (*) along the intussusceptions.
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case_images: F2
case_images: Ultrasonography (Fig. 2) revealed an ileocolic-type intussusception that contained crescent-shaped hypoechoic spots, suspected to be the leading cause, and enlarged mesenteric lymph nodes.
case_images: Abdominal computed tomography. (A) A 3-cm, crescent-shaped (arrow), low-density lesion at the top of the intussusception. (B) Ileocolic-type intussusception (arrow).
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case_images: F3
case_images: Abdominal computed tomography revealed an ileocolic-type intussusception with 3-cm, crescent-shaped, low-density lesions at the top of the intussusceptum and small lymph nodes along the intussusception (Fig. 3).
case_images: Laparoscopy view showing the intussusception. Distal ileum (a) is pulled into ascending colon (b), forming ileocolic type intussuception (arrow).
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case_images: PMC4729516_01_jkms-31-321-g004.jpg
case_images: F4
case_images: Grossly, no ischemic change of the intussuscepted bowel was observed and the appendix appeared normal (Fig. 4).
case_images: Gross and microscopic findings of the resected tissue. (A) Gross view of the formalin-fixed hemicolectomy specimen including ileum, cecum and appendix showing an ill-defined ulcerative lesion (arrow), measuring 5.5 x 4.0 cm. (B) The terminal ileum shows ulceration with diffuse tumor cell infiltration (arrow) in the mucosa and proper muscle layer in a low-magnification view (H&E stained, x 20). (C) The tumor cells have large vesicular nuclei with prominent nucleolus and thick nuclear membrane (H&E stained, x 400). (D) The subserosa and serosa of the terminal ileum show fibrosis and chronic inflammatory cell infiltration (arrow) admixed with tumor cell infiltration (Masson trichrome stained, x 20).
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case_images: PMC4729516_01_jkms-31-321-g005.jpg
case_images: F5
case_images: Histopathologically, it showed features of diffuse large B-cell lymphoma (Fig. 5).