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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