Primary appendiceal lymphoma presenting as perforated acute appendicitis.

Acute perforated appendicitis is a very rare initial presentation of appendiceal lymphoma. A case of primary lymphoma of the appendix in a 42-year-old female is reported here. The symptom was pain in the right lower quadrant of the abdomen. Surgical intervention was performed under clinical diagnosis of acute appendicitis. Grossly, the resected appendix was gangrenous and perforated. Light microscopy revealed transmural infiltration by diffuse large B-cell lymphoma with angioinvasion and tumor necrosis, resulting in perforated acute suppurative appendicitis. To the best of our knowledge, only 4 cases of well-documented primary diffuse large B-cell lymphoma of appendix have been reported in the world literature.