Primary Intestinal Lymphoma: A Clinicopathological Study.

Introduction: Primary intestinal lymphoma (PIL) is defined as an extranodal lymphoma arising in the intestine. This study includes 11 PILs. Objectives: The objective of this study was to evaluate the clinicopathological characteristics of primary non-Hodgkin's lymphoma (NHL) in the small and large intestine. All cases were reclassified according to the World Health Organization classification of lymphoma in 2001. Immunohistochemistry (IHC) was used to confirm the histopathological diagnosis. Materials and Methods: Eleven cases of primary non-Hodgkin in the small and large intestine were studied retrospectively in a 5 year period. There were seven cases of resected intestinal specimens and four biopsy specimens. Five cases from ileum and two cases each from caecum and duodenum and one case each from jejunum and duodenum. Hematoxylin and eosin stained sections were studied with light microscopy and IHC for CD5, 20, 21 and cyclin D1 were done. Results: It is a retrospective study of 11 cases of intestinal lymphomas. Abdominal pain and abdominal lump were two main common presenting symptoms. NHLs were more common in the small intestine. PILs are common in adults (75% above 46 years) with male preponderance. All were NHLs and B-cell type. Five cases were diffuse large B-cell lymphoma and four cases each were mucosa-associated lymphatic tissue lymphoma and follicular lymphoma. One case was lymphomatoid polyposis or mantle cell lymphoma. Conclusion: PILs is rare and differs significantly from their gastric counterpart, not only in pathology but also with regard to clinical features, management and prognosis. Due to the lack of characteristic symptoms and a low incidence rate, PIL is misdiagnosed until serious complications occur, such as perforation and bleeding and hence needs to be accurately diagnosed.

Unusual presentation of sickle cell anaemia--paraplegia in a fifty year old man.

A fifty-year-old male patient presented with bilateral lower limb paraplegia. He was subsequently found to have sickle cell anaemia. The patient showed good response to treatment. Central nervous system complications in sickle cell anaemia are well known. However paraplegia has rarely been documented in sickling disorders. We report this case because of rarity of sickle cell anaemia presenting in old age with paraplegia.

Paroxysmal nocturnal hemoglobinuria with onset in childhood: a case report.

A twelve-year-old boy presented with recurrent episodes of anemia. Complete blood counts showed pancytopenia. Bone marrow was hypercellular with erythroid hyperplasia and depleted stores of iron. Positive Ham's test and sucrose lysis test revealed that he had paroxysmal nocturnal hemoglobinuria. There was a delay of nearly two years in the diagnosis in this patient. Paroxysmal nocturnal hemoglobinuria is rare in childhood. It must however be considered in a child who presents with unexplained anemia or bone marrow failure so that an early and accurate diagnosis is reached.