Signet Ring Cell Lymphoma of the Small Bowel: A case report

Primary Hepatic Lymphoma Mimicking Cholangiocarcinoma

Primary hepatic lymphoma (PHL) presenting with obstructive jaundice is rare and can mimic a preoperative diagnosis of cholangiocarcinoma. We should consider PHL in patients with radiological hepatic disease with normal serum alpha-fetoprotein and carcinoembryonic antigen levels, and elevated lactate dehydrogenase. We present the case of a 67-year-old male with no significant medical history presented with abdominal pain, jaundice, fever, and abnormal liver function tests. Abdominal sonography and computed tomography scan suggested a diagnosis of obstructive jaundice and cholangitis due to cholangiocarcinoma (Klatskin tumor). A subsequent liver biopsy diagnosed PHL, and the patient was treated with combination chemotherapy, including rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). PHL should be considered in patients presenting with biliary obstruction.

A rare presentation of gastric signet ring cells: signet ring cell lymphoma

We herewith present a rare and interesting case of gastric signet ring cell lymphoma (SRCL) in a 40-year-old retroviral positive lady. SRCL is a rare morphological variant of nodal lymphomas.Biopsy from the suspected lesion in the stomach showed diffuse sheets of cells with a large central vacuole displacing the nucleus to the periphery of the cell, imparting signet ring cell morphology. Negative reaction to PAS (Periodic acid Schiff) stain and subsequent strong positivity for the immunohistochemical markers such as CD45 (Leucocyte commonantigen) and CD20, a B-cell marker helped us to arrive at a diagnosis of signet ring B- cell lymphoma.