It is on record that lymphoma of the stomach may be healed whereas that of the appendix would manifest later. Therefore, this paper documents synchronous lymphoma of both appendix and ileum among the Ibo ethnic group in Nigeria.

From Ireland [1], there arose a case in which a 61-year-old woman underwent chemotherapy for gastric lymphoma successfully but it relapsed after 8 years in the appendix. Therefore, this paper reports from a Nigerian Ibo [2]; synchronously, both ileum and appendix were inflicted with the lymphoma. This combination requires addition to the literature as a case report.

IM, a 42-year-old man, attended the Annunciation Specialist Hospital at Emene, near Enugu. There, he was seen by Sister Dr Angela Muobike. His story was that of acute abdomen. There was tenderness in the right iliac fossa. At operation, there was ascites as well as a tumor in the terminal ileum. Scattered small lumps were found in the omentum and mesentery lymph nodes. Emergency, right hemicolectomy and ileo-colic anastemosis were performed. Long coils of the bowel including variably thickened mesentery were submitted. Much thickened fatty masses included a 7 cm fatty involved appendix with scarcely any lumen. On microscopy, all sections revealed sheets of variform, hyperchromatic, round tumor cells without differentiation. Malignant melanoma was diagnosed together with metastases.

The commoner lymphomatous involvement of the appendix was not associated with other organs. Indeed, reports came from China [3], India [4], and Taiwan [5]. As for the US [6], we gather that “Although appendiceal lymphoma is rare, the characteristic CT appearance could lead to a preoperative diagnosis.” Owing to the underdevelopment of the local system, this was not part of the procedure here. Incidentally, an odd combination was seen in Belgium [7]. There, the incidental finding was of silent appendicitis accompanied by lung cancer.