Enteropathy-type T-cell lymphoma that was pathologically diagnosed as celiac disease.
A 63-year-old woman was referred and admitted to our department for further examination of protein-losing enteropathy (PLE), which was diagnosed by alpha-anti trypsin test. Her symptoms were frequent vomiting, watery diarrhea and hypoproteinemia. Although intensive examination for PLE was performed in her previous hospital, the origin of the disease was not detected. Abdominal computed tomography revealed diffuse enlargement and swelling of the intestine wall and a 5-cm diameter mass with unclear margin, which involved the mesenteric arteries and veins. Total colonoscopy showed a diffuse edematous lesion with hemorrhage at the terminal ileum. Enteropathy-type T-cell lymphoma (ETL) was diagnosed based on a biopsy of the lesion and CD45 gating analysis. Immediate start of chemotherapy (CHOP) led to a transient regression of the tumor even though her symptoms were not improved. During the second cycle of CHOP, the patient died of massive hemorrhage throughout the intestine. The pathological study revealed that intraepithelial CD3-positive clonal T-cells were present in the lesion, indicating that this case could be associated with celiac disease. In light of the histological findings, we concluded that this was a case of ETL associated with celiac disease, which is extremely rare in Japan.
Yasuoka
Hidetoshi
H
Department of Medicine and Molecular Science, Graduate School of Medicine, Gunma University, Maebashi.
Masuo
Takashige
T
Hashimoto
Koshi
K
Sato
Koji
K
Okada
Shuichi
S
Kusano
Motoyasu
M
Oishi
Takuma
T
Yokoo
Hideaki
H
Kojima
Masaru
M
Nakazato
Yoichi
Y
Mori
Masatomo
M
D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007078:Ileal Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D016399:Lymphoma, T-Cell / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D008875:Middle Aged; D011504:Protein-Losing Enteropathies / Q000209:etiology