A 73-year-old heterosexual man developed a high-grade non-Hodgkin's lymphoma at the site of an ileostomy only 2 years after proctectomy for undetermined colitis not cured by previous colectomy. In fact, the early occurrence of this usually very late and rare complication of ileostomy was probably favored by the simultaneous presence of acquired immune deficiency syndrome (AIDS) due to repeated blood transfusions for refractory anemia with excess blasts. The intestinal location of the tumor, its high-grade malignancy and B-cell origin are all features of AIDS-related non-Hodgkin's lymphoma. This case report seems to be one of the rarely identified examples of the cooperation between general predisposing factors and local irritating agents at the origin of a malignant tumor.
Cancer 651028-1032, 1990.
ON-HODGKINS LYMPHOMA (NHL) and, more gen-N erally speaking, malignant tumors are a very rare and late complication of ileostomy performed for inflammatory bowel disease (IBD).',2 We report here a new case of such a NHL tumor which occurred early after proctectomy for longstanding undetermined proctitis. An acquired immune deficiency syndrome (AIDS) due to repeated blood transfusions for refractory anemia with excess blasts was very probably responsible for the development of this tumor, whose particular location might be related to local irritative factors linked to the stoma.
Case Report
A 73-year-old heterosexual man, born in 1913, had an undetermined colitis since 1935. Several surgical operations had been performed: cecum resection in 1939, subtotal colectomy with ileorectal anastomosis in 1959, and proctectomy in 1984 with ileostomy in the right iliac fossa because of anastomosis stenosis and intractable proctitis.
Pathologic study of the resected anus, rectum, and distal ileum From the Service de Gastroenttrologie and the Unit6 de Recherches