title: A case of intestinal T-cell lymphoma with repeated episodes of perforation.
abstract: A case of intestinal cytotoxic/suppressor T-cell lymphoma with repeated episodes of perforation was seen in a 77-year-old Japanese male who was admitted complaining of severe abdominal pain accompanied by high grade fever. Surgery revealed diffuse peritonitis due to perforation in the sigmoid colon. After a loop sigmoid colostomy the patient recovered to some degree. Seven days later, however, another perforation occurred. Several aneurysmal swellings accompanied by perforation in the small intestine, forming a mass of 5 x 5 cm, were seen. Although the patient tolerated this operation, generalized emaciation proceeded and the patient died 10 days late. Histological examination at the second operation showed diffuse medium-sized lymphoma of the Lymphoma Study Group (LSG) classification infiltrating the entire depth of the intestinal wall. Destruction of muscle cells was prominent. An immunohistochemical study using fresh frozen material was positive for CD3, and CD8. This marked destruction of the muscle layer by lymphoma cells may be associated with repeated episodes of perforation.
authors.affiliation: First Department of Surgery, Kobe University School of Medicine, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Yamamoto
authors.forename: T
authors.initials: T
authors.lastname: Shiraishi
authors.forename: T
authors.initials: T
authors.lastname: Ajiki
authors.forename: Y
authors.initials: Y
authors.lastname: Imai
authors.forename: H
authors.initials: H
authors.lastname: Oyanagi
authors.forename: Y
authors.initials: Y
authors.lastname: Saito
mesh_terms: D000368:Aged; D000945:Antigens, Differentiation, T-Lymphocyte / Q000032:analysis; D017252:CD3 Complex; D016827:CD8 Antigens / Q000032:analysis; D003106:Colon / Q000473:pathology* / Q000601:surgery; D003110:Colonic Neoplasms / Q000473:pathology* / Q000601:surgery; D003125:Colostomy; D006471:Gastrointestinal Hemorrhage / Q000473:pathology; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D007416:Intestinal Perforation / Q000473:pathology* / Q000601:surgery; D007421:Intestine, Small / Q000473:pathology* / Q000601:surgery; D016399:Lymphoma, T-Cell / Q000473:pathology* / Q000601:surgery; D008297:Male; D011183:Postoperative Complications / Q000473:pathology / Q000601:surgery; D011948:Receptors, Antigen, T-Cell / Q000032:analysis; D012008:Recurrence
chemical_list: D000945:Antigens, Differentiation, T-Lymphocyte; D017252:CD3 Complex; D016827:CD8 Antigens; D011948:Receptors, Antigen, T-Cell