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David J. Hass, MD Assistant Clinical Professor of Medicine Yale University School of Medicine...
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Capsule Endoscopy: Clinical Case Vignettes David J. Hass, MD Assistant Clinical Professor of Medicine Yale University School of Medicine Gastroenterology Center of Connecticut, P.C.
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Transcript of David J. Hass, MD Assistant Clinical Professor of Medicine Yale University School of Medicine...
Capsule Endoscopy:Clinical Case Vignettes
David J. Hass, MDAssistant Clinical Professor of Medicine
Yale University School of MedicineGastroenterology Center of Connecticut, P.C.
Case # 4
72 year-old male
Profuse diarrhea and night sweats
25 pound weight loss over six months
Case # 4
Slightly cachectic
Physical exam otherwise unremarkable
Case # 4
WBC 18,000 with a slight lymphocytic predominanceNormal chemistriesESR 120
Negative celiac serologiesNormal IgA level, normal chromogranin A levelNegative stool studies
Case # 4
Negative EGDNegative ColonoscopyCT scan – borderline enlarged lymphadenopathyNormal gallium scanNormal small bowel series
A capsule endoscopy was performed….
Click to play video
Case # 4
Double balloon enteroscopy performed for tissue sampling
Diagnosis: Small bowel diffuse large B-cell lymphoma
Patient underwent CHOP chemotherapy with a good clinical response, dying of an unrelated cause 3 yrs after his diagnosis of lymphoma.
Case # 4Diffuse large B cell lymphoma of the small bowel is an
uncommon neoplasm. In contrast to gastric lymphoma, small bowel B cell lymphomas do not appear to be associated with H pylori.
Capsule endoscopy has proven useful for diagnosis of obscure causes of gastrointestinal illness. In this case, making the diagnosis of a mass lesion that was not found using other methods.
