Year 2024 / Volume 116 / Number 9
Letter
Intestinal stenosis developed after a complete response to chemotherapy in a patient with Crohn’s disease and lymphoma of the jejunum

502-504

DOI: 10.17235/reed.2023.10004/2023

Marta García Calonge, Fernando Fernández Cadenas, Helena González Sánchez, Daniel Muíño-Domínguez, Lucía Morais Bras, Mateo García Ramos, Lourdes Sanz Álvarez, Sabino Riestra,

Abstract
An increased risk of hematologic malignancies secondary to long-term immunomodulators and biologics has been described in patients with inflammatory bowel disease1. Here, we present a case of jejunal stricture after chemotherapy treatment in a patient with ileal Crohn´s disease (CD) and jejunal lymphoma. The patient was a 32-year-old male with ileal CD in remission presenting with abdominal pain and distension. Abdominal computed tomography (CT) showed a poorly defined mass in the proximal jejunum, and positron emission tomography (PET) – CT showed hypermetabolic activity at that level. An upper endoscopy evidenced an indurated, friable circumferential mass causing a significant reduction of the intestinal lumen. Histological and cytometry findings led to a diagnosis of large B cell lymphoma, for which the patient received standard treatment (R-CHOP and IPI), achieving complete response. Eight months later, the patient reported abdominal pain and distention. Abdominal CT showed a thickening of a short segment of the proximal jejunum. An upper endoscopy showed a punctiform stenosis, while multiple biopsies showed neither histological recurrence of lymphoma nor signs of IBD. The patient was diagnosed with a post-chemotherapy stricture and underwent progressive endoscopic balloon dilatation. He finally was scheduled for laparoscopic small bowel resection. An histological analysis of the surgical piece revealed a granulomatous reaction with multinucleated foreign body-like giant cells, without evidence of malignancy (recurrence of lymphoma) nor inflammatory infiltrate suggesting CD. The patient currently remains asymptomatic with no new episodes of abdominal pain.
Share Button
New comment
Comments
No comments for this article
References
1. Guerra I, Bujanda L, Mañosa M, et al; ENEIDA project of GETECCU. Clinical Presentation, Management, and Evolution of Lymphomas in Patients with Inflammatory Bowel Disease: An ENEIDA Registry Study. Cancers (Basel). 2023;15(3):750. doi: 10.3390/cancers15030750. PMID: 36765708; PMCID: PMC9913166.
2. Libicher M, Lamade W, Kasperk C, et al. Cicatricial small intestinal stenosis following chemotherapy for a gastrointestinal lymphoma. Dtsch Med Wochenschr. 1996;121(44):1359-62.
3. Kerr JP, Turner M, Ashton-Key M et al. Intestinal strictures: a new complication of treatment for primary gastrointestinal diffuse large B-cell lymphoma. Br J Haematol. 2008;140(6):712-714.
4. Gupta G, Agarwala S, Thulkar S, et al. Jejunal stricture: a rare complication of chemotherapy in pediatric gastrointestinal B-cell non-Hodgkin lymphoma. J Pediatr Hematol Oncol. 2011;33(2):e69-71.
5. Dias E, Andrade P, Cardoso H, et al. Primary small bowel follicular lymphoma: the role of balloon-assisted enteroscopy in diagnosis and follow-up. Rev Esp Enferm Dig. 2023 Jan;115(1):43-44.
Related articles

Letter

Endoscopic observation of a rare duodenal tumor

DOI: 10.17235/reed.2023.9679/2023

Letter

Primary esophageal follicular lymphoma: a rare entity

DOI: 10.17235/reed.2023.9651/2023

Letter

MALT lymphoma of the colon: an endoscopic challenge

DOI: 10.17235/reed.2023.9595/2023

Letter

Hepatosplenic T-cell lymphoma and inflammatory bowel disease

DOI: 10.17235/reed.2023.9472/2023

Letter

Primary esophageal diffuse large B-cell lymphoma

DOI: 10.17235/reed.2022.9298/2022

Letter

Colonic malignancy: always adenocarcinomas?

DOI: 10.17235/reed.2022.9223/2022

Letter

Extensive small intestinal diffuse large B cell lymphoma

DOI: 10.17235/reed.2022.9100/2022

Letter

Sepsis due to phlegmonous gastritis in a cancer patient

DOI: 10.17235/reed.2022.9009/2022

Digestive Diseases Image

Pancreatic lymphoma during pregnancy

DOI: 10.17235/reed.2022.8811/2022

Letter

Digestive tract MALT lymphoma, an unusual location

DOI: 10.17235/reed.2022.8800/2022

Letter

Intestinal occlusion due to Burkitt lymphoma: an unusual cause

DOI: 10.17235/reed.2022.8765/2022

Review

Clinical settings with tofacitinib in ulcerative colitis

DOI: 10.17235/reed.2022.8660/2022

Letter

Gastrointestinal lymphoma, a rare endoscopic lesion

DOI: 10.17235/reed.2022.8555/2021

Letter

Cecal MALT lymphoma: a challenging diagnosis

DOI: 10.17235/reed.2021.8526/2021

Letter

Anal neoplasia and perianal Crohn’s disease: myth or reality?

DOI: 10.17235/reed.2021.8317/2021

Letter

Apoptotic colopathy as a manifestation of Good’s syndrome

DOI: 10.17235/reed.2021.8297/2021

Original

Radon exposure and inflammatory bowel disease in a radon prone area

DOI: 10.17235/reed.2021.8239/2021

Digestive Diseases Image

A case of duodenal-type follicular lymphoma

DOI: 10.17235/reed.2021.8233/2021

Digestive Diseases Image

Gastroduodenal Burkitt’s lymphoma: a rare cause of epigastric pain and diarrhea

DOI: 10.17235/reed.2021.8150/2021

Digestive Diseases Image

Duodenal-type follicular lymphoma: a silent tumor

DOI: 10.17235/reed.2021.8149/2021

Review

Inflammatory bowel disease and solid organ transplantation

DOI: 10.17235/reed.2020.7361/2020

Letter

Follicular non-Hodgkin lymphoma with primary colonic involvement

DOI: 10.17235/reed.2020.6986/2020

Letter

Secondary gastric lymphoma - Do we know its endoscopic findings?

DOI: 10.17235/reed.2020.6868/2020

Editorial

Is celiac disease really associated with inflammatory bowel disease?

DOI: 10.17235/reed.2019.6779/2019

Case Report

Primary colon mantle lymphoma: a misleading macroscopic appearance!

DOI: 10.17235/reed.2019.6405/2019

Original

Megacolon in inflammatory bowel disease: response to infliximab

DOI: 10.17235/reed.2020.6394/2019

Editorial

Diet in the etiology of inflammatory bowel disease

DOI: 10.17235/reed.2018.6119/2018

Letter

Mantle cell lymphoma of the cecum

DOI: 10.17235/reed.2019.5936/2018

Case Report

Serrated Lesions in patients with Inflammatory Bowel Disease.

DOI: 10.17235/reed.2019.5910/2018

Editorial

Online social networks and inflammatory bowel disease

DOI: 10.17235/reed.2018.5496/2018

Letter to the Editor

Post-transplant lymphoproliferative disease after liver transplantation

DOI: 10.17235/reed.2017.5387/2017

Letter to the Editor

Idiopathic portal hypertension with regard to thiopurine treatment

DOI: 10.17235/reed.2018.5256/2017

Editorial

Specialist care in the management of inflammatory bowel disease

DOI: 10.17235/reed.2016.4628/2016

Case Report

Unusual involvement in mycosis fungoides: Duodenal papilla

DOI: 10.17235/reed.2015.3831/2015

Citation tools
García Calonge M, Fernández Cadenas F, González Sánchez H, Muíño-Domínguez D, Morais Bras L, García Ramos M, et all. Intestinal stenosis developed after a complete response to chemotherapy in a patient with Crohn’s disease and lymphoma of the jejunum. 10004/2023


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 364 visits.
This article has been downloaded 33 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 08/10/2023

Accepted: 11/10/2023

Online First: 26/10/2023

Published: 09/09/2024

Article Online First time: 18 days

Article editing time: 337 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology