PMC5952441_01
CT showed a hyperdense 60 x 50 mm right colic parietal lesion, signs of ileocolic intussusception with adjacent lymphadenopathy.
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Moreover, the CT showed a hyperdense 60 x 50 mm right colic parietal lesion, signs of ileocolic intussusception with adjacent lymphadenopathy measuring 20 mm (Figure 1).
Flexible colonoscopy documented a caecal large submucosal lesion with ulcerated mucosa.
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Flexible colonoscopy documented a caecal large submucosal lesion with ulcerated mucosa (Figure 2).
Trocar's disposition. Laparoscopic right hemicolectomy.
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Trendelenburg position with a slight rotation on the left flank. The surgeon was between the patient's legs, and the camera operator/assistant was on the left side (Figure 3).
Intraoperative view of ileocolic intussusception.
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Ileocolic intussusception causing occlusive status with multiple lymphadenopathies along the ileocaecal artery was observed intraoperatively (Figure 4).
Surgical specimen after opening of the colon with appearance of tumor at the ileocaecal valve.
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Gross examination of the specimen revealed a tumor mass of the ileocaecal valve measuring 50 x 45 mm which seemed infiltrate muscular layer (Figure 5).
Histological and immunohistological examination of the specimens showing diffuse large B-cell non-Hodgkin's lymphoma. (a) Magnification x400, HE staining, polymorphic large B-cells with irregular nuclei. (b) Magnification x400, CD20(+). (c) Magnification x400, CD79(+). (d) Magnification x400, Ki67/Mib1 > 95% (high-grade B-cell lymphoma).
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Proliferation index was high (Ki67/MIB-1 > 95%) (Figure 6).