title: Diffuse large B-cell lymphoma (DLBCL) in the bypassed stomach after obesity surgery.
abstract: Laparoscopic Roux-en-Y gastric bypass is the most commonly performed surgical procedure for obesity and, consequently, post-operative patients are increasingly encountered by all specialties. This is a case of a patient presenting with abdominal pain, nausea and fever 9 months following gastric bypass surgery caused by diffuse large B-cell lymphoma (DLBCL) in the bypassed stomach. It demonstrates well that symptoms that may normally be considered 'red-flags' may not be as obvious or specific following an operation. The case also indicates the importance of considering diagnoses unrelated to surgery presenting in the post-operative period (especially when conventional investigation methods are not feasible), and the potential danger of assuming they are due to the operation alone; had this occurred in this patient then a malignancy may have been missed. This is only the second reported case of DLBCL in the bypassed stomach, and the third for lymphoma of any type.
authors.affiliation: Upper GI/Bariatric Surgery, University Hospital of North Tees, Cleveland, UK.
authors.forename: M J
authors.initials: MJ
authors.lastname: Courtney
authors.forename: D
authors.initials: D
authors.lastname: Chattopadhyay
authors.forename: M
authors.initials: M
authors.lastname: Rao
authors.forename: D
authors.initials: D
authors.lastname: Light
authors.forename: B
authors.initials: B
authors.lastname: Gopinath
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D009765:Obesity / Q000601:surgery*; D011241:Prednisone / Q000627:therapeutic use; D000069283:Rituximab; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
keywords: Bariatric; Roux-en-Y; bypass; lymphoma