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Case Report

Acute appendicitis changing the clinical trajectory of a Small lymphocytic lymphoma in a patient during the coronavirus epidemic

Tommy McKitterick, Anand Trivedi.

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Small lymphocytic lymphoma (SLL) not uncommonly effects the alimentary tract although it rarely effects the veriform appendix. Patients presenting with known lymphoma and clinical presentations of acute appendicitis should be treated with an appendicectomy but consideration should be given to other differential diagnoses including proliferation of disease and early referral and discussion with haematology. A 51 year old male presenting with clinical appendicitis on a background of known SLL, due to commence chemotherapy but withheld due to the coronavirus epidemic. He was found to have elevated Lymphocytes and cross sectional imaging showed an enlarged appendix with periappendiceal inflammation as well as bulky mesenteric, retroperitoneal and inguinal lymphadenopathy. He underwent an uncomplicated appendicectomy and histolopathological analysis identified SLL with periappendiceal inflammation. Following this the patient was then deemed suitable to undergo chemotherapy in the context of Coronovirus( COVID-19) epidemic.

Key words: Appendicitis, Small Lymphocytic Lymphoma, COVID-19

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