Jejunal Perforations in Lymphoma After Chemotherapy

Abstract

Malignant lymphomas may involve the small intestine primarily or involve this area secondarily as a manifestation of generalized lymphomatous disease. In an autopsy series of 277 patients with disseminated lymphosarcoma, Rosenberg et al.¹ noted that 88 patients or 32% had involvement of the small intestine. Many of the lymphomas have been found to be unusually sensitive to the nitrogen mustards; these polyfunctional alkylating agents have been used extensively in the treatment of the disseminated lymphomas and the chronic leukemias from the time they were first introduced. Perforation of the bowel wall in patients with lymphoma involving the small intestine was considered rare in older series.^2-4 However, more recent series have reflected a much higher incidence of this complication.^5-10 Perforation of the wall of the small intestine following mechlorethamine hydrochloride (nitrogen mustard) therapy for disseminated lymphoma has not been previously reported. Morgan, Sigel, and Wolcott,¹¹ however, have