Cure8 research brief
Because intestinal lymphoma can closely mimic Crohn’s disease, recognizing red flags (severe malabsorption, proximal small-bowel involvement, monoclonal gammopathy, poor response to IBD therapy) can change diagnosis and treatment.
Clinicians who manage IBD, adult patients with refractory or atypical IBD features, and pathologists evaluating small-bowel biopsies.
A 23-year-old woman had 2 years of large-volume diarrhea, weight loss, and malabsorption treated as Crohn’s disease with corticosteroids and azathioprine and later biologic therapy but with only partial response. Evaluation showed hypoalbuminemia, elevated inflammatory markers, and a monoclonal gammopathy.
Endoscopy and imaging found ileal and jejunal disease; biopsy and immunohistochemistry demonstrated a dense lymphoplasmacytic infiltrate with CD20 and CD138 positivity and light-chain restriction, leading to a diagnosis of extranodal marginal zone lymphoma of the small intestine.
The reported treatment included combined chemotherapy with planned escalation to rituximab-based therapy because of suboptimal response.
What to watch for: The authors emphasize reconsidering the diagnosis when patients presumed to have IBD have atypical features such as severe malabsorption, proximal small-bowel predominance, monoclonal protein, or refractory disease despite appropriate IBD therapies.
Early tissue diagnosis with targeted histopathology and immunostains was decisive in this case.
This is a single case report (abstract-level summary). Findings illustrate a diagnostic pitfall but do not provide generalizable rates or outcomes. Monoclonal gammopathy and specific immunohistochemistry were key to the lymphoma diagnosis in this patient.
Review the original publication for the complete reporting, methods, and context.
This Cure8 brief is based on source text from the linked article. Cure8 is informational only and is not a substitute for professional medical advice, diagnosis, or treatment.
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