An unusual case of fever and a sigmoid mass.
A 52-year-old Afro-Caribbean female presented with a 2-week history of left iliac fossa pain and persistent fever. The working diagnosis was diverticulitis and she was treated with intravenous antibiotics. A CT scan of the abdomen showed a thickened sigmoid colon lying adjacent to the left bladder wall with inflammatory changes present. As the patient's condition showed no improvement, an explorative laparotomy was performed, which identified a mass in the sigmoid colon adherent to the bladder and left ovary. An anterior resection, partial cystectomy and a defunctioning loop-ileostomy were performed. Postoperatively, spiking fever with a high white cell count continued. No postoperative surgical complications were identified despite numerous investigations. Eventually, histology of the colon revealed a null type anaplastic large cell lymphoma with a high proliferation fraction of greater than 90%.
Department of General Surgery, Barnet Hospital, Herts, UK.
Tamara
T
Kubba
Mio
M
Takatsuka
Eve
E
Stern
Thomas
T
Smith
Jason
J
Lee
Maitham
M
Al-Whouhayb
Michael
M
Saunders
D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D017728:Lymphoma, Large-Cell, Anaplastic / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D012811:Sigmoid Neoplasms / Q000150:complications / Q000175:diagnosis*