Yonsei Med J.  2009 Dec;50(6):859-861. 10.3349/ymj.2009.50.6.859.

Case of Small Bowel Perforation due to Enteropathy-Type T-Cell Lymphoma

• Kim YS
• Choi YS
• Park JS
• Kim BG
• Cha SJ
• Chi KC
• Park SJ
• Chang IT
• Park SI

• KMID: 1777105
• DOI: http://doi.org/10.3349/ymj.2009.50.6.859

Abstract

Enteropathy-type T-cell lymphoma (ETTL) is a rare disease with a poor prognosis. According to the World Health Organization (WHO) classification, it is a subtype of the peripheral T-cell lymphomas. This disease is associated with gluten-sensitive enteropathy, has a high risk of intestinal perforation and obstruction, and is refractory to chemotherapeutic treatment. We report the case of a 73-year-old woman who was diagnosed with enteropathy-type T-cell lymphoma of the small intestine, which was positive for the markers of cytotoxic T cells, CD3, CD8, and CD56, on immunohistochemical staining after resection of the perforated terminal ileum.

Keyword

Enteropathy-type T-cell lymphoma; celiac disease; intestinal perforation

MeSH Terms

Aged
Celiac Disease/*complications/pathology
Female
Gastrointestinal Neoplasms/*complications/pathology
Humans
Intestinal Perforation/*diagnosis/*etiology/pathology
Lymphoma, T-Cell/*complications/pathology

Figure

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  Fig. 1 CT: wall thickening with central necrosis in small bowel and lymphadenopathies near the mass.

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  Fig. 2 A gross pathological specimen: a well-defined encircling mural mass and perforated ulcers.

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  Fig. 3 Histopathological findings in the affected terminal ileum. (A) Diffuse infiltration of atypical lymphocytes with irregularly shaped nuclei (Hematoxylin-Eosin stain, ×400). (B) Lymphoma cell infiltration by CD3-positive and CD20-negative T lymphocytes (immunohistochemical stain, ×400).

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