AN INTERESTING CASE OF ILEAL MASS(NON-HODGKINS LYMPHOMA OF ILEUM)

AN INTERESTING CASE OF ILEAL MASS(NON-HODGKINS LYMPHOMA OF ILEUM)Report Of A Case And Review Of The Literature Non - Hodgkins Lymphoma is a proliferation of discrete masses with in Lymphnodes, Spleen or Extranodal tissues apart from Hodgkins Lymphoma which has its clinical and histological distinction. Gastrointestinal tract is the commonest extranodal site for Lymphoma. Diagnostic criteria for primary gastrointestinal lymphoma includes absence of Superficial lymphadenopathy on physical examination, absence of Mediastinal lymphadenopathy on chest imaging, Normal peripheral blood counts, .A 36 years old male patient presented with complaints of pain in the right lower abdomen for 3 days duration with history of vomiting and fever. On examination patient was afebrile, tachycardia was present. There was no generalized lymphadenopathy, per abdominal examination there was tenderness in the right iliac fossa, maximum tenderness in the Mc Burneys point with localised guarding and rebound tenderness, no mass palpable, Bowel sounds were sluggish. Provisional clinical diagnosis was Acute Appendicitis. On Ultrasonagraphy of the abdomen an irregular hypoechoic lesion measuring 6.3 x 4.3 x 5.4 cm with air pockets was seen with features suggestive of Appendicular Abscess. Emergency Exploratory Laparotomy was done, intra operatively an inflammatory mass measuring 8 x 6 cm was found around 10 cm proximal to the Ileocaecal Junction in the distal Ileum with Omental adhesions. Hence Ileal mass Resection Anastomosis was done. Post operative period was uneventful. Histopathological examination proved to be high grade NON-HODGKINS LYMPHOMA.ConclusionPrimary Gastrointestinal Non-Hodgkins Lymphoma is a rare condition. Incidence of Primary Ileal Lymphoma is 3 of all lymphomas. These patients can rarely present with intestinal perforation, bleeding and obstruction.