Hepatosplenic T-gammadelta lymphoma in a patient with Crohn's disease treated with azathioprine.
Hepatosplenic gammadelta T-cell lymphoma (HS-gammadeltaTCL) is an uncommon type of peripheral T-cell lymphoma, which has been associated in some cases with immunosuppression, mainly after solid organ transplants. We describe a case of HSgammadeltaTCL with a leukaemic course in a patient with Crohn's disease who had received azathioprine during the previous 5.5 years. Sinusoidal infiltration by atypical lymphocytes was observed in the liver, spleen and bone marrow and the typical cytogenetic abnormalities (isochromosome 7 and trisomy 8) were found. The patient did not respond to intensive chemotherapy. This case shows the importance of ruling out HSgammadeltaTCL in patients with hepatosplenomegaly, B-symptoms and any immunosuppressive condition.
Navarro
José-Tomás
JT
Department of Haematology, Hospital Universitari Germans Trias i Pujol, Badalona, Universitat Autònoma de Barcelona, Barcelona, Spain.
Ribera
Josep-Maria
JM
Mate
José-Luis
JL
Granada
Isabel
I
Juncà
Jordi
J
Batlle
Montserrat
M
Millá
Fuensanta
F
Feliu
Evarist
E
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000150:complications* / Q000188:drug therapy; D001379:Azathioprine / Q000009:adverse effects / Q000627:therapeutic use; D002869:Chromosome Aberrations; D003131:Combined Modality Therapy; D003424:Crohn Disease / Q000150:complications* / Q000188:drug therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004338:Drug Combinations; D017809:Fatal Outcome; D005944:Glucosamine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D016130:Immunophenotyping; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000150:complications* / Q000188:drug therapy; D016411:Lymphoma, T-Cell, Peripheral / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D008297:Male; D011241:Prednisone / Q000008:administration & dosage; D016692:Receptors, Antigen, T-Cell, gamma-delta / Q000032:analysis*; D013156:Splenectomy; D013160:Splenic Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D012460:Sulfasalazine / Q000627:therapeutic use; D014750:Vincristine / Q000008:administration & dosage
D000305:Adrenal Cortex Hormones; D004338:Drug Combinations; D007166:Immunosuppressive Agents; D016692:Receptors, Antigen, T-Cell, gamma-delta; C028423:Salazopyrine; D012460:Sulfasalazine; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D001379:Azathioprine; D005944:Glucosamine; D011241:Prednisone