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Capsule Endoscopy: Clinical Case Vignettes

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. Case # 4. 72 year-old male Profuse diarrhea and night sweats 25 pound weight loss over six months.

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Capsule Endoscopy: Clinical Case Vignettes

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  1. 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.

  2. Case # 4 • 72 year-old male • Profuse diarrhea and night sweats • 25 pound weight loss over six months

  3. Case # 4 • Slightly cachectic • Physical exam otherwise unremarkable

  4. Case # 4 • WBC 18,000 with a slight lymphocytic predominance • Normal chemistries • ESR 120 • Negative celiac serologies • Normal IgA level, normal chromogranin A level • Negative stool studies

  5. Case # 4 • Negative EGD • Negative Colonoscopy • CT scan – borderline enlarged lymphadenopathy • Normal gallium scan • Normal small bowel series • A capsule endoscopy was performed….

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  7. 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.

  8. Case # 4 • Diffuse 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.

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