title: Enteropathy-type T-cell lymphoma showing repeated small bowel rupture and refractoriness to chemotherapy: a case report.
abstract: The majority of gastrointestinal lymphomas arise in the stomach, whereas lymphomas occurring in the intestine are relatively rare and a limited fraction of them show the T-cell phenotype with clinical manifestations similar to de novo celiac disease. Enteropathy-type T-cell lymphoma is extremely rare in Japan, presumably owing to the very low incidence of celiac disease among the Japanese population. Here, we report a 66-year-old Japanese male who was diagnosed as having enteropathy-type T-cell lymphoma preceded by diarrhea and intermittent bloody stool for over 1 year. He was admitted to our hospital as an emergency case because of panperitonitis due to intestinal perforation. After immediate partial small-bowel resection, cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) chemotherapy was started. However, the disease was highly refractory and was exacerbated with leukemic transformation. Subsequent salvage chemotherapy could not be completed because of the formation of spontaneous jejuno-abdominal fistula, followed by fatal septic shock. Particular attention should be paid to the peculiar clinical manifestations of enteropathy-type T-cell lymphoma such as malnutrition, frequent intestinal perforation and refractoriness to chemotherapy.
authors.affiliation: Hematology Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Itaru
authors.initials: I
authors.lastname: Kataoka
authors.forename: Fumitou
authors.initials: F
authors.lastname: Arima
authors.forename: Junko
authors.initials: J
authors.lastname: Nishimoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Watanabe
authors.forename: Yukio
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Ryuji
authors.initials: R
authors.lastname: Tamura
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Matsuno
authors.forename: Tadakazu
authors.initials: T
authors.lastname: Shimoda
authors.forename: Kensei
authors.initials: K
authors.lastname: Tobinai
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D003520:Cyclophosphamide / Q000009:adverse effects; D004317:Doxorubicin / Q000009:adverse effects; D005047:Etoposide / Q000009:adverse effects; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology*; D007414:Intestinal Neoplasms / Q000150:complications / Q000188:drug therapy*; D007416:Intestinal Perforation / Q000209:etiology*; D007579:Jejunal Diseases / Q000209:etiology*; D016399:Lymphoma, T-Cell / Q000150:complications / Q000188:drug therapy*; D008297:Male; D011241:Prednisone / Q000009:adverse effects; D012422:Rupture, Spontaneous; D014750:Vincristine / Q000009:adverse effects
chemical_list: D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone