Author:

Abstract

A 56-year old man presented at the emergency department with a history fever and pain in the left lower abdomen. He was already treated with antibiotics for several weeks by his general practitioner because of suggested diverticulitis. Because of the prolonged course a computed tomography (CT) scan of the abdomen and the pelvis was performed. CT revealed a large mass of the sigma with marked narrowing of the lumen (Fig. A). The mass contained hypodense areas and air suggesting necrosis. In contact to the lesion one enlarged lymph node with a diameter of 3 cm could be found (Fig. B). Biopsy obtained during optical colonoscopy showed a high grade lymphoma. Staging with neck- and chest-CT revealed no further enlarged lymph nodes. There were three larger pulmonary nodules in accordance with a pulmonary manifestation of the patient’s lymphoma. As there were no signs of gastrointestinal obstruction no surgical intervention was performed and chemo - therapy was started immediately after diagnosis. The patient just received the first cycles of his chemotherapy and is doing well.