A Case Report of Monomorphic Epithelial Intestinal T-Cell Lymphoma and Literature Review

Abstract

Background: Monomorphic epithelial intestinal T-cell lymphoma (MEITL), previously known as type II Enteropathy-associated T-cell lymphoma (EATL), is a rare intestinal tumor with strong invasiveness, poor prognosis, atypical clinical manifestations, and is difficult to diagnose. Aim: The clinical manifestations, imaging, histopathology, and immunohistochemical characteristics, treatment and prognosis of this case of MEITL were analyzed retrospectively, and combined with literatures learning to provide the experiences and lessons for diagnosis and treatment. Case Presentation: Here, we present a 68-year-old Asian woman with unexplained intestinal perforation and lung imaging changes as the first manifestation, and gradually appearing refractory diarrhea and pulmonary cavities. During the period, due to the unknown diagnosis, all treatments were mainly based on anti-infection and antidiarrhea, but her symptoms had no improvement after therapy, even died of poor basic physical conditions. Colonoscopy biopsy showed atypical lymphocyte infiltration-like growth and the formation of local superficial ulcers. Immunohistochemical tests showed that T-lymphocyte hyperplasia was predominant and led to a diagnosis of MEITL. Conclusion: MEITL is mainly manifested by gastrointestinal symptoms and lacks specific symptoms. The diagnosis of MEITL should be based on comprehensive judgment of clinical manifestations, pathological features and immunohistochemical detection results. Positive biopsy confirmed and timely chemotherapy may be conductive to a better prognosis.

Monomorphic Epitheliotropic Intestinal T-Cell Lymphoma Presenting With Jejunal Perforation: A Challanging Diagnosis

“…Although obstruction is a common presentation, diagnosis of MEITL was made possible only after the segmental resection of a perforated segment as seen in our case and also mentioned by others [8]. Recently, a similar case of MEITL was reported which was also treated with anti-infective and anti-diarrheal therapy due to previous unknown diagnosis and ultimately the patient died due to poor physical condition [9].…”