Monomorphic epitheliotropic intestinal T-cell lymphoma of the duodenum: an aggressive disease

Kasinathan, Ganesh

doi:10.1016/j.htct.2020.04.005

Cited by 8 publications

(4 citation statements)

References 8 publications

(8 reference statements)

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“…Outcomes from our case and others in the literature suggest that surgical resection may not be associated with improved survival in patients with MEITL 1. While MEITL is most frequently located in the jejunum, duodenal lesions have been previously reported and can result in obstructive jaundice, obstruction and gastrointestinal bleeding 4 7. A similar case to our patient was reported where the patient underwent gastrojejunal bypass rather than resection.…”

Section: Discussionsupporting

confidence: 71%

“…A similar case to our patient was reported where the patient underwent gastrojejunal bypass rather than resection. This patient received several cycles of anthracycline chemotherapy, but had progression of disease, failed salvage chemotherapy treatment, and ultimately expired less than a year after diagnosis 4…”

Section: Discussionmentioning

confidence: 99%

“…While the most common site of involvement of MEITL is the jejunum,2 previous cases of duodenal involvement have been documented 3 4. The clinical presentation of MEITL includes non-specific gastrointestinal complaints such as abdominal pain and diarrhoea, with many patients ultimately diagnosed after acute complications such as intestinal perforation or gastrointestinal bleeding 2.…”

Section: Introductionmentioning

confidence: 99%

“…There is no standardised treatment for MEITL, resulting in heterogeneous use of surgery, chemotherapy, radiation and autologous stem cell transplantation 4. Previous studies have shown that a majority of patients undergo some surgical intervention for histological confirmation of diagnosis or management of an acute surgical complication 2.…”

Section: Introductionmentioning

confidence: 99%

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Pancreatoduodenectomy for monomorphic epitheliotropic intestinal T-cell lymphoma with duodenal obstruction

2022

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We report an unusual case of a woman in her 60s diagnosed with monomorphic epitheliotropic intestinal T-cell lymphoma who required a pancreatoduodenectomy (Whipple procedure) for duodenal obstruction. The patient was initially treated with several cycles of chemotherapy, with persistent disease of the duodenum at D3. She was symptomatic with obstructive symptoms and positron emission tomography (PET)-CT showed disease localised to the duodenum without evidence of active disease elsewhere. The patient underwent pancreatoduodenectomy for both palliation of obstructive symptoms and potential oncological benefit. The patient had mild symptoms of delayed gastric emptying requiring promotility agents postoperatively, but otherwise recovered well after surgery. Unfortunately, surgical pathology revealed diffuse disease through the resected portion of the duodenum and jejunum, with positive proximal and distal margins. We suspect she has diffuse small bowel disease which was occult by CT and PET-CT. Based on this case, we recommend consideration of bypass rather than resection when possible for surgical palliation due to likelihood for extensive bowel involvement.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pancreatoduodenectomy for monomorphic epitheliotropic intestinal T-cell lymphoma with duodenal obstruction

2022

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PEG-Asparaginase Single-Agent Rescue in an Advanced Case of Monomorphic Epitheliotropic Intestinal T Cell Lymphoma

Barbieri

Pozzi

Gelmini

et al. 2022

J Gastrointest Canc

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MEITL is a very rare and highly aggressive peripheral T-cell lymphoma with poor prognosis and for which there is no standard treatment. Patients with relapsed/refractory disease have few treatment options and many still die of disease progression. Here we report the case of a 65-year-old woman affected by MEITL, progressing after initial treatment with an anthracycline-based chemotherapy and surgery, who received single-agent PEG-asparaginase salvage therapy at our institution. The treatment proved to be rapidly effective in controlling the disease and its associated paraneoplastic features. Nevertheless, toxicity was high and the patient died due to a treatment-related complication. The case we described brings new evidences on the effectiveness of PEG-asparaginase therapy in MEITL patients. Whether PEGasparaginase should be included in the treatment course of MEITL patients could be the subject of future studies.

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Small bowel T-cell lymphoma: a MEITL-ing diagnosis

Mago

Mavilia

Forouhar

et al. 2021

Clin J Gastroenterol

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Monomorphic epitheliotropic intestinal T-cell lymphoma of the duodenum: an aggressive disease

Cited by 8 publications

References 8 publications

Pancreatoduodenectomy for monomorphic epitheliotropic intestinal T-cell lymphoma with duodenal obstruction

Pancreatoduodenectomy for monomorphic epitheliotropic intestinal T-cell lymphoma with duodenal obstruction

PEG-Asparaginase Single-Agent Rescue in an Advanced Case of Monomorphic Epitheliotropic Intestinal T Cell Lymphoma

Small bowel T-cell lymphoma: a MEITL-ing diagnosis

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