Small intestine lymphoma?

I am a 27 male and have been having GI symptoms for almost a year and a half now, which have included intermittent, crampy abdominal pain, bloating, borborygmi, and altered bowel habits and stool consistency.

Over the summer I had a CT scan, which revealed a mildly prominent spleen.  A GI series revealed mild thickening of the jejunum and a transient intussusception.  Upper and lower endocscopies were normal.  Various blood panels were normal, including a peripheral smear. Recently, a stool sample revealed traces of carbohydrates and fat, and recently my stools do seem to fit the description of steatorrhea.

I'm being treated for pancreatic insufficiency by taking enzymes but it's not helping.  I've had blood tests and an upper endoscopy, which would rule out celiac.

I am extremely concerned that this is a rare variant of primary small intestine lymphoma.  The thickening of the jejunum and the malabsorption particularly worry me.

Does lymphoma seem possible to you, or likely? Can there be idiopathic reasons for malabsorption, or perhaps even stress? If there is malabsorption, can this still be IBS?

[Kevin Pho, MD]

I can't predict the probability of whether lymphoma is present or not without an examination and a review of the studies.  

That said, I agree with the tests done thus far.  If there is concern about the thickening, the best way to get a definitive answer would be through a biopsy.  

Malabsorption can be evaluated with blood tests for celiac disease, as well as an analysis of the stool.  

If the tests remain negative, then indeed, IBS is possible.  Treatment options in this case would include increasing fiber in the diet or antispasmodic agents.

These options can be discussed with your personal physician.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin Pho, M.D.
www.kevinmd.com
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