title: Primary colonic lymphoma: An incidental finding in a patient with a gallstone attack.
abstract: We report a case of primary colonic lymphoma incidentally diagnosed in a patient presenting a gallbladder attack making particular attention on the diagnostic findings at ultrasound (US) and total body computed tomography (CT) exams that allowed us to make the correct final diagnosis. A 85-year-old Caucasian male patient was referred to our department due to acute pain at the upper right quadrant, spreaded to the right shoulder blade. Patient had nausea and mild fever and Murphy's maneuver was positive. At physical examination a large bulky mass was found in the right flank. Patient underwent to US exam that detected a big stone in the lumen of the gallbladder and in correspondence of the palpable mass, an extended concentric thickening of the colic wall. CT scan was performed and confirmed a widespread and concentric thickening of the wall of the ascending colon and cecum. In addition, revealed signs of microperforation of the colic wall. Numerous large lymphadenopathies were found in the abdominal, pelvic and thoracic cavity and there was a condition of splenomegaly, with some ischemic outcomes in the context of the spleen. No metastasis in the parenchimatous organs were found. These imaging findings suggest us the diagnosis of lymphoma. Patient underwent to surgery, and right hemicolectomy and cholecystectomy was performed. Histological examination confirmed our diagnosis, revealing a diffuse large B-cell lymphoma. The patient underwent to Cyclophosphamide, Hydroxydaunorubicin, Oncovin, Prednisone chemotherapy showing only a partial regression of the lymphadenopathies, being in advanced stage at the time of diagnosis.
authors.affiliation: Silvia Gigli, Valeria Buonocore, Flavio Barchetti, Marianna Glorioso, Martina Di Brino, Pietro Guerrisi, Francesco Giovagnorio, Department of Radiological Sciences, "Sapienza" University of Rome, Umberto I Hospital, 00161 Rome, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Gigli
authors.affiliation: Silvia Gigli, Valeria Buonocore, Flavio Barchetti, Marianna Glorioso, Martina Di Brino, Pietro Guerrisi, Francesco Giovagnorio, Department of Radiological Sciences, "Sapienza" University of Rome, Umberto I Hospital, 00161 Rome, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Buonocore
authors.affiliation: Silvia Gigli, Valeria Buonocore, Flavio Barchetti, Marianna Glorioso, Martina Di Brino, Pietro Guerrisi, Francesco Giovagnorio, Department of Radiological Sciences, "Sapienza" University of Rome, Umberto I Hospital, 00161 Rome, Italy.
authors.forename: Flavio
authors.initials: F
authors.lastname: Barchetti
authors.affiliation: Silvia Gigli, Valeria Buonocore, Flavio Barchetti, Marianna Glorioso, Martina Di Brino, Pietro Guerrisi, Francesco Giovagnorio, Department of Radiological Sciences, "Sapienza" University of Rome, Umberto I Hospital, 00161 Rome, Italy.
authors.forename: Marianna
authors.initials: M
authors.lastname: Glorioso
authors.affiliation: Silvia Gigli, Valeria Buonocore, Flavio Barchetti, Marianna Glorioso, Martina Di Brino, Pietro Guerrisi, Francesco Giovagnorio, Department of Radiological Sciences, "Sapienza" University of Rome, Umberto I Hospital, 00161 Rome, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Di Brino
authors.affiliation: Silvia Gigli, Valeria Buonocore, Flavio Barchetti, Marianna Glorioso, Martina Di Brino, Pietro Guerrisi, Francesco Giovagnorio, Department of Radiological Sciences, "Sapienza" University of Rome, Umberto I Hospital, 00161 Rome, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Guerrisi
authors.affiliation: Silvia Gigli, Valeria Buonocore, Flavio Barchetti, Marianna Glorioso, Martina Di Brino, Pietro Guerrisi, Francesco Giovagnorio, Department of Radiological Sciences, "Sapienza" University of Rome, Umberto I Hospital, 00161 Rome, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Buonocore
authors.affiliation: Silvia Gigli, Valeria Buonocore, Flavio Barchetti, Marianna Glorioso, Martina Di Brino, Pietro Guerrisi, Francesco Giovagnorio, Department of Radiological Sciences, "Sapienza" University of Rome, Umberto I Hospital, 00161 Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Giovagnorio
authors.affiliation: Silvia Gigli, Valeria Buonocore, Flavio Barchetti, Marianna Glorioso, Martina Di Brino, Pietro Guerrisi, Francesco Giovagnorio, Department of Radiological Sciences, "Sapienza" University of Rome, Umberto I Hospital, 00161 Rome, Italy.
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Giraldi
keywords: Computed tomography; Diffuse large B-cell lymphoma; Gallstone attack; Gastrointestinal lymphoma; Primary colonic lymphoma