Blood tests for Mr. Trung at Tam Anh General Clinic in District 7 revealed severe anemia and a low platelet count. A colonoscopy identified many polyp-like lesions along the duodenum, ileum, and colorectum. A large tumor in the ileocecal valve region almost completely obstructed the bowel lumen. Pathology results confirmed small cell lymphoma (low-grade lymphoma) at an advanced stage, with invasion into the spleen, liver, and lymph nodes in the abdomen, chest, and neck.

Dr. Hoang Van Tuu, from the Endoscopy Unit, noted that lymphoma lesions in the digestive tract often resemble polyps, leading to potential misdiagnosis. Using magnified imaging combined with electronic chromoendoscopy, doctors could clearly visualize abnormal vascular structures, allowing for multiple biopsies to accurately identify lymphoma instead of polyps.

Mr. Trung did not require polyp removal during the colonoscopy due to the precise diagnosis, avoiding unnecessary intervention. Typically, lymphoma tends to infiltrate deeper into the layers of the intestinal wall (submucosa, muscle layer), making surgery prone to complications such as gastrointestinal bleeding, perforation, and post-resection infection. Instead, the patient received an internal medicine protocol involving chemotherapy, radiation therapy, and targeted drugs for approximately 3 to 8 months to control the disease and reduce systemic symptoms. According to Dr. Tuu, if the patient responds well to the treatment regimen, a complete cure is possible.

Dr. Tuu performs an endoscopy for a patient. Photo: Tam Anh General Hospital

The lymphatic system, a part of the immune system, functions as a filter to remove germs and foreign substances entering the body. Approximately 800 lymph nodes are distributed throughout the body. Lymphoma occurs when a type of white blood cell belonging to the immune system grows and proliferates abnormally. The disease can originate in any area with lymphatic tissue, such as the abdomen, neck, armpits, groin, mediastinum, bone marrow, and nervous system. Gastrointestinal lymphoma accounts for 1-4% of all gastrointestinal malignancies.

Gastrointestinal lymphoma often presents with non-specific symptoms such as indigestion, bloating, abdominal pain, vomiting, and diarrhea, which are easily mistaken for other conditions and often lead to late detection. At this advanced stage, tumors can be large and palpable. Individuals with lymphoma in the ileocecal region may feel abdominal masses, enlarged liver and spleen, and numerous palpable lymph nodes throughout the body.

Dr. Tuu advises everyone to undergo regular health check-ups. Older adults should have routine digestive endoscopies for early detection of abnormalities. Individuals experiencing unexplained fever or night sweats should seek medical attention for diagnosis and appropriate treatment.

Quyen Phan

*Patient's name has been changed