An unusual case of fever and a sigmoid mass. (30th March 2011)

• Record Type: Journal Article
• Authors: Kubba, Tamara; Takatsuka, Mio; Stern, Eve; Smith, Thomas; Lee, Jason; Al-Whouhayb, Maitham; Saunders, Michael
• Is Part Of: BMJ case reports. Volume 2011
• Publication Date: 2011-03-30
• Subjects: Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr.07.2010.3196
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : 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%.