A Case of Enteropathy-Type T-Cell Lymphoma Diagnosed by Small Bowel Enteroscopy: A Perspective on Imaging-Enhanced Endoscopy

Bae, Jun Yong; Ko, Bong Min; Min, Seul Ki; Lee, Jong Chan; Lee, Gun Wha; Yoon, La Young; Hong, Su Jin; Lee, Moon Sung; Kim, Hee Kyung

doi:10.5009/gnl.2012.6.4.516

Cited by 6 publications

(5 citation statements)

References 24 publications

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“…They reported that diffuse mucosal thickening and edema with multiple shallow ulcerations, and a nodular or mosaic mucosal pattern were characteristics of the disease. 8 – 10 In our cases, small bowel was almost always involved and colonic involvement was found in half the patients. Endoscopy of the small intestine revealed multiple circular or semicircular shallow ulcerations covered with whitish mucus-like exudate.…”

Section: Discussionmentioning

confidence: 51%

Endoscopic Findings of Enteropathy-Associated T-Cell Lymphoma Type II: A Case Series

et al. 2016

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Enteropathy-associated T-cell lymphoma (EATL) is a rare extranodal T-cell lymphoma arising from the intestine. Two types of EATL have been reported. In contrast to the classic EATL type I, EATL type II occurs sporadically, is unrelated to celiac disease, and comprises 10% to 20 % of all EATL cases. A total of five cases of EATL type II were diagnosed at our clinic from January 2009 to September 2012. Four of the five patients were diagnosed with the help of endoscopy. Among the four patients, two of the cases involved both the small and large intestines, whereas in the other two patients, EATL was limited to the small intestine. Common endoscopic findings included innumerable fine granularities (also called mosaic mucosal patterns) and diffuse thickening of the mucosa with a semicircular shallow ulceration in the lesions of the small bowel. In contrast, the endoscopic findings of the colon were nonspecific and could not distinguish EATL type II from other diseases. There are only few published reports regarding the representative endoscopic findings of EATL. Here, we present the clinical and endoscopic findings of four cases of EATL type II diagnosed by endoscopy.

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Section: Discussionmentioning

confidence: 51%

Endoscopic Findings of Enteropathy-Associated T-Cell Lymphoma Type II: A Case Series

et al. 2016

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“…Diffuse mucosal thickening and edema with multiple shallow ulcerations, and a nodular or mosaic mucosal pattern are typically present. 34 Radiographic features in barium studies are not specific and include polypoid form, multiple nodules, infiltrative form, endoexoenteric form with excavation and fistulization, and mesenteric invasive form with an extraluminal mass.…”

Section: Resultsmentioning

confidence: 99%

Extranodal diffuse large B-cell lymphomas: A retrospective case series and review of the literature

et al. 2018

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Non-Hodgkin lymphomas commonly show extranodal involvement (25-30%) but primary diffuse large B-cell lymphomas (DLBCL) with extranodal localization represent clinically and molecularly distinct entities. The present study involved retrospective analysis of case records of 4 patients who were diagnosed with extranodal DLBCL between 2010 and 2016 at the Medical Oncology and Hematology Departments of the Ioannina University Hospital, Greece. Median age of presentation was 69 years (range 60-77 years). There were 2 males and 2 females. The sites of DLBCL involvement included adrenal gland, mandible, cervix uteri, and ileum. Two patients had B symptoms while none had bone marrow involvement. After staging workup, all the patients fell into IE stage. The treatment approach included chemotherapy combined with rituximab (R), whereas one patient received additionally irradiation therapy. Post-treatment positron emission tomography-computed tomography scan was performed in 3 patients. In terms of the outcome, 3 patients are alive in complete response, whereas one was lost in follow-up. Further prospective data analyses are required so as to better elucidate the biology and course of extranodal DLBCL.

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“…MEITL of the small intestine is difficulty to diagnosis and is frequently associated with non-specific symptoms. Many cases are diagnosed after emergent surgery for perforation or obstruction, as occurred in this patient 6. Given the low incidence of the disease, available evidence is minimal and therefore no current guidelines exist regarding optimal diagnosis or treatment 1.…”

Section: Discussionmentioning

confidence: 99%

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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A Case of Enteropathy-Type T-Cell Lymphoma Diagnosed by Small Bowel Enteroscopy: A Perspective on Imaging-Enhanced Endoscopy

Cited by 6 publications

References 24 publications

Endoscopic Findings of Enteropathy-Associated T-Cell Lymphoma Type II: A Case Series

Endoscopic Findings of Enteropathy-Associated T-Cell Lymphoma Type II: A Case Series

Extranodal diffuse large B-cell lymphomas: A retrospective case series and review of the literature

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

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