Introduction:

The gastrointestinal tract is the principal site of extralymphatic lymphoma, corresponding to 5-20% of the cases. Near 90% of the primary gastrointestinal lymphoma (PGL) are from B cells.

Case report:

Male of 61 years, with bowel obstruction and a tumor in right iliac fossa. In surgery we found citrine liquid in cavity, a tumor in proximal ileum, mesenteric lymph nodes, and intraluminal implant in the small intestine, greater omentum, mesenteric root and sigmoid peritoneum. In the pathological assessment it was reported non-Hodgkin diffuse small cells lymphoma in ileum with involvement of mesenteric lymph nodes, greater omental nodes, sigmoid colon and the appendix. The immunohistochemistry staining revealed follicular intestinal lymphoma of B cells, positivity for CD 20 and Ki-67 with cell proliferation of 5%.

Discussion:

To define PGL we use the Dawson criteria: a predominately gastrointestinal tract lesion, with or without spread to regional nodes, no involvement of the peripheral or mediastinal nodes, no involvement of the liver or spleen, and a normal white cell count and differential. Actually, the surgery is indicated in case of bleeding, perforation or obstruction, followed by adjuvant chemotherapy.

Conclusion:

The clinical presentation of PGL may be obstruction with or without perforation, as the case we report in which we found extension to mesenteric lymph nodes as to greater omentum, a rare finding, so the peritoneal lymphomatosis is a possibility when we found a tumor in the terminal ileum.

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