title: Enteropathy-associated T-cell lymphoma type II complicated by autoimmune hemolytic anemia.
abstract: A 74-year-old man was admitted to hospital because of persistent fever, diarrhea, and abdominal pain. CT scanning showed extensive wall thickening of the colon. He was transferred to our hospital because he further developed ascites and paraaortic lymph node swelling. On presentation, he was extremely emaciated with superficial lymph node swelling, ascitic signs, and leg edema. Histological image of a biopsied mesenteric lymph node demonstrated diffuse infiltration of large abnormal T cells. Surface antigen analysis of abnormal cells in the ascites revealed positivity for CD3, CD8, CD56, and weak positivity for CD103. Polymerase chain reaction analysis showed monoclonal rearrangement of the T cell receptor (TCR) gene. The subtype of TCR was αβ. A diagnosis of enteropathy-associated T cell lymphoma (EATL) type II was made. The lymphoma involved the bone marrow. The patient also had severe hemolytic anemia with a positive Coomb's test result. An additional diagnosis for autoimmune hemolytic anemia (AIHA) was made, which was resistant to methylprednisolone therapy. We first treated him with only vincristine in addition to the steroid to avoid acute tumor lysis syndrome ; however, he died of septic shock that occurred soon after vincristine administration. To the best of our knowledge, this may be the first reported case of EATL complicated by AIHA.
authors: Departments of Hematology and Clinical Immunology, Kobe City Medical Center General Hospital, Japan. aikokato@kcho.jp
authors: Aiko
authors: A
authors: Kato
authors: Yoko
authors: Y
authors: Takiuchi
authors: Kazunari
authors: K
authors: Aoki
authors: Yuichiro
authors: Y
authors: Ono
authors: Hiroshi
authors: H
authors: Arima
authors: Seiji
authors: S
authors: Nagano
authors: Sumie
authors: S
authors: Tabata
authors: Soshi
authors: S
authors: Yanagita
authors: Akiko
authors: A
authors: Matsushita
authors: Hayato
authors: H
authors: Maruoka
authors: Masaya
authors: M
authors: Wada
authors: Yukihiro
authors: Y
authors: Imai
authors: Takayuki
authors: T
authors: Ishikawa
authors: Takayuki
authors: T
authors: Takahashi
mesh_terms: D000368:Aged; D000744:Anemia, Hemolytic, Autoimmune / Q000097:blood / Q000276:immunology* / Q000473:pathology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D058527:Enteropathy-Associated T-Cell Lymphoma / Q000097:blood / Q000276:immunology* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000473:pathology; D008297:Male