Rare presentation of B-lymphoblastic leukemia/lymphoma with intussusception in an adult

B-lymphoblastic leukemia/lymphoma (B-ALL/LBL), not otherwise specified, is a neoplasm of B-cell precursor lymphoid cells. Most these tumors tend to manifest in children. B-LBL constitutes about 10% the lymphoblastic lymphomas; however, older adults, it extremely rare. We present case 46-year-old man with no pertinent medical or surgical history who presented severe abdominal pain, nausea, and emesis. An CT scan was suggestive strangulation distal small bowel ischemia, showed extensive matted lymphadenopathy mesentery, multiple left suprarenal periaortic nodes. A resection performed there an ileocolonic intussusception right colon filled intussuscepted terminal ileum. Opening specimen revealed submucosal ileal mass that measured 3 × 2.2 1.3 cm well-circumscribed, yellow-white cut surface. Histological examination diffuse infiltrate composed small- medium-sized cells extending through wall from mucosa subserosa, irregular nuclear contours, open chromatin, inconspicuous nucleoli, occasional mitoses, frequent apoptotic bodies. Flow cytometric analysis 29% B-lymphoblasts corresponding diagnosis B-LBL. BCR/ABL translocation by FISH detected. Cytogenetics normal male karyotype 46,XY. rare adults can involve nodal extranodal sites; gastrointestinal tract rarely compromised, only few cases reported literature.