A CASE OF OBSTRACTION OF DUODENUM CAUSED BY MALIGNANT LYMPHOMA

We experienced a case of malignant lymphoma of the duodenum presented as obstraction of the same organ. A 23-year-old female complained of nausea and vomiting. On admission, laboratory data revealed microcytic and hypochromic anemia and a decreased number of white blood cell, but its analysis and bone marrow were normal. Occult blood was admitted. Hypotonic duodenography and gastrointestinal fiberscopy showed that the third portion of the duodenum was completely obstructed by a tumor with irregular surface. The tumor was diagnosed as Non-Hodgkins' lymphoma of medium sized cell type by histological examination of the biopsy specimen. Laparotomy was performed, and an elevated tumor with irregular surface which ran up the whole-surcumference was seen at the third portion of the duodenum. Furthermore, metastases were seen in the mesocolic lymphonodes, but the liver and spleen were intact. On the following histologic examination, the preoperative diagnosis was confirmed. No monoclonality was observed in the tumor cell immunoglobulin. Surface phenotype studies of the tumor cells were all negative. ACOP theraphy was performed ten times from the second week after the operation. She was alive and well 1 year after the operation.