Association Between Crohn’s Disease and Diffuse Large B-Cell Lymphoma:A Case Report
K Gharbi*, H Moustahfid, S Soukrat, BA Yeingue and R Akka
We report the case of a 48-year-old man who presented with chronic watery diarrhea and Koenig’s syndrome localized to the right iliac fossa (characterized by postprandial cramping abdominal pain due to transient small bowel obstruction, often associated with borborygmi and abdominal distension, usually relieved by passage of gas or stool) in a context of general health deterioration. Colonoscopy with biopsy revealed active ileocecal Crohn’s disease. However, the enteroscanner findings were discordant, showing ileitis with a stenosing cecal mass. The patient was initially treated with corticosteroids without improvement and subsequently underwent ileocecal resection. Despite surgery and five months of thiopurine therapy, his condition did not improve. A follow-up abdominal CT scan revealed a large mass in the right iliac fossa. After multidisciplinary discussion, a biopsy of the mass was performed, and histopathology confirmed a diffusé large B-cell lymphoma (DLBCL). The patient received six cycles of R-CHOP chemotherapy, with clinical improvement according to his treating hematologist. However, his Crohn’s disease remained severely active, leading to a discussion about initiating ustekinumab therapy.
