J Korean Med Sci.  2024 Feb;39(6):e66. 10.3346/jkms.2024.39.e66.

Case 19: A 65-Year-Old Man With Melena and Hematochezia

• Lee H
• Choe Y
• Heo J
• Park GH
• Lee SY
• Cho YW
• Kim HS

• KMID: 2553309
• DOI: http://doi.org/10.3346/jkms.2024.39.e66

Figure

• 

  Fig. 1 Endoscopic findings in a patient who came to the emergency room with melena and hematochezia. (A) Normal findings on esophagogastroduodenoscopy, (B) Normal findings on colonoscopy, (C) Eythema and ulcers in the proximal jejunum on capsule endoscopy.

• 

  Fig. 2 Imaging and endoscopic findings in a patient admitted with second gastrointestinal bleeding. (A) Abdomen pelvis computed tomography findings showed no lesions that could cause bleeding; gallbladder stone, atrophied both kidneys, and aneurysmal dilatation of abdominal aorta were observed. (B) Normal esophagogastroduodenoscopy findings, (C) Colonoscopy findings covered with hematochezia, (D) Suspected jejunal ulcers on small bowel capsule endoscopy.

• 

  Fig. 3 Ulcerofungating mass observed in the stomach and jejunum. (A) Stomach and (B) proximal jejunum.

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  Fig. 4 Pathological findings. (A) H&E stain (×200). (B) Positive for CD20, a B cell marker. (C) High Ki-67 proliferation index.H&E = hematoxylin and eosin.

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  Fig. 5 Lymphoma of the stomach and small bowel on positron emission tomography and computed tomography. (A) Axial view, (B) Coronal view.There is intense multifocal FDG uptake in the stomach (SULmax: 17.9). FDG uptake is also seen in the jejunal loop of the left upper quadrant and the small bowel loop of the right-side abdomen. There is intense nodular FDG uptake in the mesentery. Aneurysmal dilatation is seen in the abdominal aorta.FDG = fluorodeoxyglucose, SULmax = standardized uptake value normalized by lean body mass for maximum.

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