Video Endoscopic Sequence 1 of 10.

Lymphoma B small cells of the Jejuno

This 60 year-old male, presented with vomiting, abdominal pain, weakness, fatigue, and diarrhea and weigh lost of 20 pounds, a cat scan of the abdomen showed a thickness of the omeantum with abdominal adenopathies with images of cat scan of segmental part of jejuno with thickness, at endoscopy shows a vegetal fiber impactation which cause small bowel obstruction due to a intestinal stenosis, the fiber were partially removed and fragmented with the diathermy loop.

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Video Endoscopic Sequence 2 of 10.

Jejunal Lymphoma

20-30 cm after the angle of Treitz, there are neoplastic infiltration.

Primary gastrointestinal non-Hodgkin lymphomas (NHLs) are a heterogeneous group of unique B- and T-cell lymphoid malignancies.

Their pathology, clinical features, management, and prognosis may differ from lymphomas of lymph node origin.

As an example, indolent lymphomas of lymph node origin are almost always disseminated at diagnosis, have frequent bone marrow involvement, generally respond to therapy, but continuously recur.

Median survival can exceed 10 years, although cure is unusual.

Video Endoscopic Sequence 3 of 10.

Diffuse Small B-Cell Lymphoma Complicated With Jejunal Stricture

Gastrointestinal lymphomas comprise a group of distinct clinicopathological entities.

Differences in lifestyle and environmental factors between countries could account for the variety in the distribution of the main subtypes:

low-grade B-cell lymphomas of the mucosa-associated lymphoid tissue type, alpha-chain disease and enteropathy (celiac disease)-associated T-cell lymphoma (EATL).

The possibility of preventing these lymphomas implies a knowledge of their natural history together with an identification of potential predisposing factors.

Video Endoscopic Sequence 4 of 10.

A narrowness of the jejuno is displayed in this image as well as the video clip.

The development of the lymphoid hyperplasia and subsequently low-grade lymphoma with the possibility of high-grade transformation is a multifactorial process involving both antigenic and host-related factors.

The pathogenic role of Helicobacter pylori and gluten has been demonstrated in gastric lymphoma and enteropathy-associated T-cell lymphoma respectively, while environmental factors, especially non-specific bacterial ones, may play a major role in the pathogenesis of alpha-chain disease.

The most difficult task in preventing these lymphomas is the recognition of early lesions likely to regress after the removal of the exogenous stimulus.

Video Endoscopic Sequence 5 of 10.

Endoscopy of Lymphoma B small cells of the Jejuno

Narrowness and infiltrates due to this lymphoma

Small intestinal tumors (tumors of the duodenum, jejunum, and ileum) are uncommon in comparison with those occurring elsewhere in the gastrointestinal tract.

Although the small intestine is approximately 20 ft long, comprising 75% of the length of the gastrointestinal tract and 90% of its mucosal surface area, less than 2% of malignant gastrointestinal tumors are derived from this organ.

Video Endoscopic Sequence 6 of 10.

Endoscopy of Lymphoma B small cells of the Jejuno

Circular infiltration of jejunal wall with lymphoma. Patient was placed under chemotherapy.

Primary small intestinal tumors are diverse in nature because they are derived from both epithelial and mesenchymal components of the small bowel.

The most frequent histological types of primary malignant tumors include adenocarcinomas, carcinoids, lymphomas, and sarcomas (most are now classifi ed as gastrointestinal stromal tumors).

Video Endoscopic Sequence 7 of 10.

Low power of non Hodgking lynphoma infiltrating the yeyunal wall and mucosa

Video Endoscopic Sequence 8 of 10.

Medium power view of the lymphoma infiltrating the yeyuno

Video Endoscopic Sequence 9 of 10.

High power of the same case

Video Endoscopic Sequence 10 of 10.

CD20 B cells lynphoma