A malignant lymphoma involving the gastrointestinal tract may present as an intestinal perforation. Early recognition and aggressive management can be life-saving.
Risk factors for perforation:
(1) large tumor
(2) high-grade
(3) during or shortly after chemotherapy
(4) occurrence at a location with higher intra-luminal pressures
(5) endoscopic biopsy of the tumor
Types of malignant lymphoma reported include:
(1) Burkitt’s lymphoma
(2) mantle cell lymphoma
(3) T-cell lymphoma
(4) Hodgkin’s lymphoma
(5) MALT lymphoma
Differential diagnosis:
(1) leakage at an anastomosis
(2) opportunistic infection with bowel perforation
(3) perforation at the site of a carcinoma or sarcoma
It is important to examine the site of the perforation carefully in order to determine the cause if possible.
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