Rare Case of Non-Hodgkin Lymphoma Manifesting as intestinal intussusception in HIV Patient
In a rare clinical finding, an aggressive diffuse large B-cell non-Hodgkin lymphoma served as the pathological lead point for intestinal intussusception in an HIV-positive adult, highlighting the vital importance of prioritizing malignant etiologies in immunocompromised patients presenting with bowel obstruction.
These findings of the case report are published in the Panamerican Journal of Trauma, Critical Care & Emergency Surgery in December 2025, by Jennifer Abreu and her colleagues from the Department of General Surgery.
The case underscores the necessity for clinicians to maintain a high index of suspicion for malignant intussusception in adults with bowel obstruction, as diagnostic delays significantly increase morbidity and mortality. This is particularly critical in HIV-positive patients, where the strong association with aggressive lymphomas necessitates urgent surgical and oncological intervention to ensure timely management.
A 44-year-old male with human immunodeficiency virus who reported three months of intermittent abdominal pain underwent diagnostic imaging, including computed tomography (CT), which revealed signs of a bowel obstruction and a filling defect in the jejunal loop. After an exploratory laparotomy identified an intussusception caused by an ileal mass, surgeons performed a resection and primary anastomosis for what was diagnosed as diffuse large B-cell non-Hodgkin's lymphoma (NHL), leading to a successful discharge 72 hours later.
Mechanistically, the adult form of this condition differs fundamentally from pediatric cases because it almost always requires a focal pathological lead point, such as a tumor, to physically draw one segment of the intestine into another. In patients with an underlying immunodeficiency, aggressive B-cell malignancies frequently act as these mechanical triggers, rapidly compromising the intestinal lumen and necessitating urgent surgical intervention to prevent further complications such as necrosis.
Clinical Relevance and Implementations
The implications of the case for medical practice emphasize that while computed tomography remains the gold standard for diagnosis, the treatment of choice for adults must remain surgical resection rather than manual reduction to address the substantial risk of underlying malignancy. These findings suggest that for practitioners, a history of immunodeficiency should significantly lower the threshold for pursuing aggressive diagnostic imaging and surgical consultation when patients present with non-specific abdominal symptoms, as this proactive approach improves overall patient outcomes.
Reference
Abreu J, Caraballo MG, Herrera MA, et al. Non-Hodgkin’s Lymphoma Debuting as Intussusception in Adults—A Rare Form of Presentation: A Case Report. Panamerican Journal of Trauma, Critical Care & Emergency Surgery 2025; 14(3): 178–181. The Digital Object Identifier (DOI) associated with this publication is 10.5005/jp-journals-10030-1492.
