Monomorphic Epitheliotropic Intestinal T-Cell Lymphoma With Extraintestinal Areas of Peripheral T-Cell Lymphoma Involvement

Afzal, Anoshia; Esmaeili, Azadeh; Ibrahimi, Sami; Farooque, Umar; Gehrs, Bradley

doi:10.7759/cureus.10021

Cited by 4 publications

(9 citation statements)

References 10 publications

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“…It is a rare intestinal tumor, accounting for 1.7% of all malignant lymphomas[ 8 ] and less than 10%-16% of gastrointestinal lymphomas[ 9 ]. MEITL differs from EATL (previously EATL type I) in that it predominantly affects Asian populations and is not associated with celiac disease[ 10 ]. Histologically, it consists of monomorphic small- to medium-sized cells that usually express CD3, CD8 and CD56, but not CD30[ 3 , 4 ].…”

Section: Discussionmentioning

confidence: 99%

Monomorphic epitheliotropic intestinal T-cell lymphoma presenting as melena with long-term survival: A case report and review of literature

Ozaka

Inoue

Okajima

et al. 2021

WJG

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BACKGROUND Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is a rare primary intestinal T-cell lymphoma, previously known as enteropathy-associated T-cell lymphoma type II. MEITL is an aggressive T-cell lymphoma with a poor prognosis and high mortality rate. The known major complications of MEITL are intestinal perforation and obstruction. Here, we present a case of MEITL that was diagnosed following upper gastrointestinal bleeding from an ulcerative duodenal lesion, with recurrence-free survival for 5 years. CASE SUMMARY A 68-year-old female was admitted to our hospital with melena and mild anemia. An urgent esophagogastroduodenoscopy (EGD) revealed bleeding from an ulcerative lesion in the transverse part of the duodenum, for which hemostatic treatment was performed. MEITL was diagnosed following repeated biopsies of the lesion, and cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy was administered. She achieved complete remission after eight full cycles of CHOP therapy. At the last follow-up examination, EGD revealed a scarred ulcer and 18 Fluorodeoxyglucose ( 18 FDG) positron emission tomography/computed tomography showed no abnormal FDG accumulation. The patient has been in complete remission for 68 mo after initial diagnosis. CONCLUSION To rule out MEITL, it is important to carefully perform histological examination when bleeding from a duodenal ulcer is observed.

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Section: Discussionmentioning

confidence: 99%

Monomorphic epitheliotropic intestinal T-cell lymphoma presenting as melena with long-term survival: A case report and review of literature

Ozaka

Inoue

Okajima

et al. 2021

WJG

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“…The WHO classification scheme of 2017 recognizes 4 subtypes of intestinal T-cell lymphoma: enteropathy-associated T-cell lymphoma, monomorphic epitheliotropic intestinal T-cell lymphoma, intestinal T-cell lymphoma, not otherwise specified, and indolent T-cell lymphoproliferative disorder of the GI tract (provisional). [4] MEITL occurs at a wide range of ages with a median age of 58 years and with a male to female ratio of 2:1. [35] MEITL is an aggressive lymphoma that involves not only the gastrointestinal tract, but also extensive systemic involvement, and there are case reports of brain involvement.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pegylated liposomal doxorubicin (PLD)-containing regimen as a novel treatment of monomorphic epithelial intestinal T-cell lymphoma (MEITL): A case report and review of literature

Chen

Shan

et al. 2022

Medicine

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Introduction: Monomorphic intestinal T-cell lymphoma (MEITL) is a rare, aggressive peripheral T-cell lymphoma that arises from intestinal epithelial lymphocytes. Currently, MEITL lacks standard treatment options. Under the current treatment regimen, the median survival time for patients is only 7 months. Chemotherapy followed by hematopoietic stem cell transplantation may improve patient outcomes. New anti-lymphoma drugs, including chidamide and PEG-asparaginase, are being tested against MEITL. To our knowledge, there are currently no data on the pegylated liposomal doxorubicin (PLD) regimen for MEITL therapy. Patient concerns, diagnosis and interventions:We report the case of a 54-year-old patient diagnosed with MEITL who presented with abdominal pain and was treated with a cyclophosphamide, doxorubicin, vincristine, prednisone, etoposide regimen containing PLD.Outcomes: After 15 months of follow-up, the patient is currently alive and disease free. The application of doxorubicin liposomes in chemotherapy regimens may be a new way to treat MEITL.Review: We searched the literature on MEITL and selected 52 case reports. We summarized the clinical characteristics and treatment of 53 patients (including the current patient). Conclusion:It highlights 2 important clinical findings. First, for patients with MEITL treated with the cyclophosphamide, doxorubicin, vincristine, prednisone, etoposide regimen, PLD has fewer adverse reactions and better long-term survival than doxorubicin. Second, an early diagnosis is necessary for prompt treatment. We believe that this manuscript will be valuable to all the researchers who are interested in.

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“…[4,5] Its clinical, morphologic, and immunophenotypic features distinguishing it from the more common EATL (previously EATL type I) make it a separate entity and due to its poor prognosis, it needs to be distinguished from inflammatory diseases and less aggressive T-cell lymphoma. [2,6] MEITL has a worldwide distribution, and it accounts for the vast majority of cases of primary intestinal T-cell lymphoma occurring in Asia and which also appears to occur with increased frequency in males, who are affected more often than females, the male-to-female ratio being approximately 2:1. [1] The small intestine is the most often involved in this type of lymphoma, with the jejunum affected more often than the ileum.…”

Section: Monomorphic Epitheliotropic Intestinal T-cell Lymphoma (Meit...mentioning

confidence: 99%

Proteomics and genomics of a monomorphic epitheliotropic intestinal T-cell lymphoma: An extremely rare case report and short review of literature

et al. 2022

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Rationale: Monomorphic epitheliotropic intestinal T-cell lymphoma, formerly known as enteropathy-associated T-cell lymphoma, is an extremely rare, aggressive peripheral extranodal T-cell lymphoma, that is infrequent in native European and Caucasian populations. The current study presents the clinicopathological features, diagnostic approach, and clinical outcomes of this rare entity of lymphoma and highlights the importance of the early diagnosis of monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL).Patient concerns: Main symptoms and/or important clinical findings: We present the case of a 69-year-old male patient presenting with an abdominal mass, intestinal transit disorder, and weight loss. The abdominal computed tomography (CT) revealed features suggestive of a malignancy. Following clinical and imaging investigations, surgical resection of the small intestine with other areas of involvement has been performed and further to the histopathological examination and immunohistochemical testing are mandatory.Diagnoses and Interventions: Histopathological evaluation of the tumor revealed a proliferation of medium-to largesized monomorphic lymphocytes, with vesicular nuclei, prominent nucleoli, and a moderate amount of clear to pale eosinophilic cytoplasm, with an association of infrequent Reed-Sternberg-like cells. Immunohistochemical assessment of the aforementioned tumor using CD3, CD8, CD5, CD20, and CD30 confirmed the T cell proliferation line and the monomorphic epitheliotropic intestinal T-cell lymphoma diagnosis.Lessons: The current report highlights the importance of early diagnosis of MEITL owing to its poor prognosis and presents histopathological features that help distinguish MEITL from inflammatory bowel diseases and less aggressive T-cell lymphomas.

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Monomorphic Epitheliotropic Intestinal T-Cell Lymphoma With Extraintestinal Areas of Peripheral T-Cell Lymphoma Involvement

Cited by 4 publications

References 10 publications

Monomorphic epitheliotropic intestinal T-cell lymphoma presenting as melena with long-term survival: A case report and review of literature

Monomorphic epitheliotropic intestinal T-cell lymphoma presenting as melena with long-term survival: A case report and review of literature

Pegylated liposomal doxorubicin (PLD)-containing regimen as a novel treatment of monomorphic epithelial intestinal T-cell lymphoma (MEITL): A case report and review of literature

Proteomics and genomics of a monomorphic epitheliotropic intestinal T-cell lymphoma: An extremely rare case report and short review of literature

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