A 78-year-old woman was admitted to our hospital with high fever and obvious melena. The serum level of soluble IL-2 receptor was markedly high (1,910 U/ml), and an irregular mass was found 4 cm from the anal margin on digital examination. Abdominal computed tomography demonstrated the circumferential wall thickening of the lower rectum with peritumoral inframmatory changes. Colorectal endoscopy showed an easily-bleeding tumor with ulcer formation at 4 cm from the anal margin. We made a diagnosis of malignant tumor, possibly malignant lymphoma, originating from the lower rectum. We performed abdominoperineal resection with D2 lymph node dissection. The final diagnosis was extranodal NK/T-cell lymphoma originating from the rectum, with positive CD8, EBER and TIA-1 antibody reaction. The patient received postoperative chemotherapy with DeVIC (carboplatin, etoposide, ifostamide and dexamethasone), but died due to disseminated intravascular coagulation syndrome following disease recurrence.
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