title: A new subtype of Hodgkin's lymphoma, syncytial nodular sclerosing: first case report of primary small bowel lymphoma.
abstract: BACKGROUND
  Gastrointestinal lymphomas may arise as a component of systemic disease with GI involvement or primary neoplasm. The diagnosis of primary GI lymphoma requires the lack of peripheral or mediastinal lymphadenopathy, normal white blood cell count, and differential on the peripheral blood smear; tumor involvement must be predominantly in the GI tract, and no evidence of liver or spleen involvement. The small bowel accounts for approximately 9% of the GI lymphomas.
  
  
  METHODS
  We describe a first case of primary small bowel Hodgkin's lymphoma syncytial variant nodular sclerosing type. A 28-year-old man with history of long-term use of immuno-suppressive agent and steroid presents with partial obstructing abdominal-mass-causing anemia and lower gastrointestinal bleeding. The patient underwent colonoscopy because of progressive microcytic anemia. Colonoscopy revealed non-specific polyps that were non-bleeding. The patient continued to have symptoms of abdominal cramping and twitching sensation that led to serial of small bowel radiology studies which showed multiple filling defects and a partial small bowel obstruction. The patient underwent small bowel resection, which showed Hodgkin's lymphoma syncytial variant type of nodular sclerosing.
  
  
  CONCLUSIONS
  This presentation is uncommon and, so far, there are less than ten cases reported with syncytial variant (SV) type of nodular sclerosing Hodgkin's lymphoma (NSHD). All of which have presentation above the diaphragm and, to our knowledge, this represents the first case that primary SV type of NSHD originated from the small intestine.
authors.affiliation: Staten Island University Hospital, Staten Island, New York, NY, USA.
authors.forename: Anh T
authors.initials: AT
authors.lastname: Nguyen
authors.forename: Shahreyar
authors.initials: S
authors.lastname: Hashemi
authors.forename: Michael R
authors.initials: MR
authors.lastname: Castellano
authors.forename: Michael
authors.initials: M
authors.lastname: Eisenbraun
authors.forename: Gene F
authors.initials: GF
authors.lastname: Coppa
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D006084:Graft Rejection / Q000517:prevention & control; D006689:Hodgkin Disease / Q000276:immunology* / Q000473:pathology*; D006801:Humans; D016867:Immunocompromised Host; D007414:Intestinal Neoplasms / Q000276:immunology* / Q000473:pathology*; D007421:Intestine, Small / Q000473:pathology*; D016030:Kidney Transplantation; D008297:Male
chemical_list: D000305:Adrenal Cortex Hormones