PMC8010170_01
Colonoscopy. There are multiple irregular ulcers in the colon. (A) Ascending colon. (B) Sigmoid colon.
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F1
A total of three colonoscopes and biopsies were performed for the patient, and the results showed multiple irregular ulcers in the whole colon (Figure 1).
Whole abdominal CT. CT scan showing wall thickening of the colon (arrows). CT scan showing a large amount of free gas in abdominal cavity (arrow). (A) Coronal view. (B) Sagittal view.
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F2
CT images of chest and neck were normal. Contrast-enhanced CT scan of the whole abdomen revealed multi-segmental intestinal wall thickening and enhancement (Figure 2A). 18F-FDG PET/CT demonstrated increased FDG uptake in the whole colon, bone marrow and spleen (Figure 3). DNA fragment of Mycobacterium tuberculosis was found by qPCR. During the hospitalization, the patient developed a fierce abdominal pain, CT indicated gastrointestinal perforation (Figure 2B).
F-18 fluorodeoxyglucose positron emission tomography with computed tomography (18F-FDG PET/CT) showing significant increased FDG uptake in the intestinal wall of the whole colon. (A) Body maximum intensity projection (MIP) image. (B) abdominal PET/CT.
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F3
CT images of chest and neck were normal. Contrast-enhanced CT scan of the whole abdomen revealed multi-segmental intestinal wall thickening and enhancement (Figure 2A). 18F-FDG PET/CT demonstrated increased FDG uptake in the whole colon, bone marrow and spleen (Figure 3).
Histological and immunohistochemical pictures of the lymphoma. (A) The tumor cells infiltrated the whole wall of the colon. (B) Diffusely infiltrating of medium-sized tumor cells with irregular nuclei (arrows). Immunohistochemical stains showing the tumor cells are positive for (C) CD3, (E) CD43, (G) GB, and (H) EBER, and negative for (D) CD5, (F) CD56. (I) The Ki-67 labeling index was around 60%.
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F4
Histologically, the tumor cells were medium in size with irregular nuclei (Figure 4B). The tumor cells infiltrated the whole wall of the intestinal wall with ulcer, necrosis (Figure 4A). TIA-1 were positive, while CD20, CD5, CD7, CD4, CD8, CD56 were negative (Figures 4B-G). CD30 was focally positive. The Ki-67 labeling index was 60% (Figure 4I). EBV-encoded small RNA (EBER) analysis showed positive (Figure 4H).