Case Report


Gastric actinomycosis facilitated by diffuse large B-cell lymphoma

,  ,  ,  

1 Resident, Department of Internal Medicine Ikazia Hospital, Rotterdam The Netherlands

2 Internist, Department of Internal Medicine Ikazia Hospital, Rotterdam The Netherlands

3 Clinical Pathologist, Department of Pathology Maasstad Hospital, Rotterdam The Netherlands

4 Clinical Pathologist, Department of Pathology Maasstad Hospital, Rotterdam The Netherlands

Address correspondence to:

Adriaan Dees

Dr. Ikazia Hospital, Montessoriweg 1, 3083 AN, Rotterdam,

The Netherlands

Message to Corresponding Author


Article ID: 100965Z01RS2018

doi: 10.5348/100965Z01RS2018CR

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How to cite this article

Singh RD, de Boer F, Teune TM, Dees A. Gastric actinomycosis facilitated by diffuse large B-cell lymphoma. Int J Case Rep Images 2018;9:100965Z01RS2018.

ABSTRACT


Introduction: Gastric actinomycosis is a rare endogenous infection caused by Actinomyces species and is usually provoked by gastric mucosal damage, for example due to previous abdominal surgery or trauma. As the clinical presentation and invasive nature of actinomycosis often mimics malignancy, the diagnosis is sometimes only established after exploratory laparotomy.

Case Report: Here, we present a male in his seventies, with lowgrade B-cell chronic lymphatic leukemia, in whom gastric actinomycosis was diagnosed by histopathological examination of endoscopic biopsies. Repeated endoscopic examination following antibiotic treatment revealed an underlying diffuse large B-cell lymphoma, interpreted as a Richter’s transformation. The patient received six Rituximab, Cyclophosphamide, Adriamycin, Vincristine, and Prednisone (R-CHOP) chemotherapy courses, after which complete remission was achieved.

Conclusion: We emphasize that a high level of vigilance is necessary to diagnose gastric actinomycosis and the possibility of a concomitant malignancy should be considered.

Keywords: A. israelii, B-cell lymphoma, Gastric acinomycosis, Richter’s transformation

SUPPORTING INFORMATION


Author Contributions:

Ranjit Dhillon Singh - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Fransien de Boer - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Thea Marieke Teune - Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Adriaan Dees - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Guaranter of Submission

The corresponding author is the guarantor of submission.

Source Of Support

None

Consent Statement

Written informed consent was obtained from the patient for publication of this case report.

Data Availability

All relevant data are within the paper and its Supporting Information files.

Conflict of Interest

Authors declare no conflict of interest.

Copyright

© 2018 Ranjit Dhillon Singh et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.


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