CLINICAL PRESENTATION A 56-year-old gentleman presented with a 6-week history of fatigue, drenching night sweats and 6 kg of weight loss. Clinical examination revealed a palpable right iliac fossa mass. He had a history of hypertension. Full blood count, differential white count and blood film were unremarkable. Inflammatory markers were elevated: C reactive protein 66 mg/l (range 0e8 mg/l) and erythrocyte sedimentation rate 36 mm/h. Immunoglobulin G (IgG) was raised at 18.5 g/l (range 6e13 g/l) with a negative autoantibody screen. Contrast-enhanced computerised tomography demonstrated a mass at the ileocaecal junction involving the ascending colon with local and mesenteric lymphadenopathy (figure 1A,B). Ileocolonoscopy revealed a prominent ileocaecal valve only, and biopsies were normal.
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