A CASE OF MALIGNANT LYMPHOMA OF THE DUODENUM PRESENTED WITH METASTASIS TO THE ABDOMINAL WALL

A very rare case of malignant lymphoma of the duodenum which presented with metastasis to the abdominal wall and progressed rapidly is reported. A 51-year-old man was seen at the hospital because he noticed of a tumor in the upper portion of the navel. Abdominal ultrasonography revealed a 3.0×3.0×2.0cm subcutaneous tumor. The tumor was enucleated under local anesthesia. Histopathologically it was malignant lymphoma of diffuse, B cell lymphoma, medium-sized type. The patient was followed on ambulant basis for treatment of the surgical wound, when he became to complain of epigastric discomfort. Close examination of the gastrointestinal tract revealed that the pylorus swelled like edema manifesting pyloric stenosis. Biopsy showed a malignant lymphoma of diffuse, B cell lymphoma, medium sized type arisen from the duodenum. The tumor of the abdominal wall was diagnosed as metastasis of malignant lymphoma of the duodenum based on clinical and imaging findings. Furthermore, abdominal CT and chest CT scan revealed hepatic and pulmonary metastases, and so one course of VEPA regimen was performed. The patient, however, developed MOF and died.