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Abdominal MRI (coronal and axial) sections. Note the displacement on the left of the uterus due to the "mass effect" of the tumor.
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MRI revealed, on the left side and in the abdominal centre, the presence of jejunal loops moderately overstretched by liquid with thickened wall of some sections of the small intestine; on the right, the jejunal loops appeared collapsed in a conglomerate appearance, without cleavage planes: here there was thickening of the posterior peritoneum and irregular thickening of the omental apron, delimiting the intestinal mass (Fig. 1).
Intra-operative finding. Neoplastic intestinal mass with intestinal subverted structure (arrow).
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After closing the uterine breach, the surgical team continued the operating session, highlighting a large neoplastic mass starting from the root of the mesentery that infiltrated the corresponding small loop (Fig. 2).
(A-D). Neoplastic lymphoid population with diffused pattern of infiltration and <<starry sky>> aspect (A); in B, neoplastic population made by large, atypical lymphocytes. Note cellular atypia with nucleoli and mytosis (C-D).
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Immuno-histochemical studies showed positivity for cellular myc oncogene (cMYC) and no B-cell CLL/lymphoma 6 (Bcl6) and B-cell lymphoma 2 (bcl2) translocations were found: diagnosis of sporadic variant BL (not endemic, not immunodeficiency associated) was confirmed (Fig. 3, Fig. 4).