A 55-year-old man, identified as Ashwin Pranjapye (name changed), experienced severe abdominal discomfort, bloating, weight loss, and intermittent diarrhea for two months. Initial blood tests were normal, but an abdominal imaging revealed enlarged lymph nodes. A screening endoscopy detected intestinal ulcers, and biopsy confirmed diffuse large B-cell lymphoma of the intestine. A PET CT scan showed liver involvement, indicating stage IV B-cell lymphoma.
Understanding Intestinal Lymphoma
Intestinal lymphoma is a type of non-Hodgkin lymphoma (NHL), a blood cancer affecting the lymphatic tissues of the gastrointestinal tract. Depending on subtype and stage, it can spread to lymph nodes, bone marrow, or other organs. India records approximately 41,607 new NHL cases and 11,230 Hodgkin lymphoma cases annually. Lymphomas constitute a significant portion of blood cancers, with NHL accounting for nearly 77.5% of all lymphoma cases.
Treatment and Recovery
After diagnosis, the patient was admitted to an adult HaemOnc unit. Given the advanced stage, he received advanced immunotherapy with Polatuzumab and Rituximab combined with standard-of-care therapy. He completed the treatment over five months and remains in remission one and a half years after initiating therapy.
Dr. Punit L Jain, Lead Consultant in Haematology, Haemato-Oncology, Bone Marrow Transplant and CAR T-cell Therapy at Apollo Hospitals, Navi Mumbai, stated, “Intestinal lymphomas are often difficult to diagnose early because symptoms such as abdominal pain, bloating, altered bowel habits, or weight loss can initially appear non-specific and overlap with common gastrointestinal conditions.” He added that treatment planning today is increasingly personalized, depending on disease stage, tumor biology, patient fitness, treatment tolerance, and expected quality of life outcomes.
Dr. Jain noted, “In this case, despite the disease being diagnosed at an advanced stage, Mr. Pranjapye responded very well to a combination treatment strategy that incorporated targeted immunotherapy.”
Evolving Treatment Landscape
Over recent years, lymphoma management has evolved significantly with increased use of targeted immunotherapy, antibody-drug conjugates, and precision-based strategies alongside conventional chemotherapy. Besides medication, management includes maintaining nutrition, monitoring treatment tolerance, infection prevention, emotional reassurance, and long-term follow-up. These steps enable meaningful remission and improved quality of life.
More than a year after completing therapy, the patient remains in complete remission and has returned to normal daily activities. Although advanced lymphomas carry a 20-30% chance of recurrence, his recovery offers hope to many patients with advanced stages.
