LAUSR

ple well defined hypo-echoic lesions were demonstrated within the bowel wall suggesting a lymphoma. A laparotomy was performed and a very thickened distal terminal ileum and caecum was noted. No bowel biopsies were obtained because of concern about perforation. Biopsies from multiple lymph nodes showed reactive changes without clonality. The intussusception was reduced and she made an uneventful recovery. Subsequent morbidity has included marked sub-mental infective adenitis requiring surgical drainage on two occasions. She remains on monthly IVIG replacement without abdominal symptoms or signs. Annual ultrasound abdominal screening continues to demonstrate multiple mesenteric and bowel wall nodes.