title: Enteropathy-associated intestinal T-cell lymphoma in cavitating mesenteric lymph node syndrome: fine-needle aspiration contributes to the diagnosis.
abstract: Cavitating mesenteric lymph node syndrome (CMLNS) is an infrequently reported manifestation of unrecognized/longstanding celiac disease and may be associated with enteropathy-associated intestinal T-cell lymphoma and hyposplenism. Unrecognized malignancy and life-threatening infections can pose a significant risk to patients in cases of delayed diagnosis. Fine-needle aspiration of the mesenteric lesions may contribute significantly to the correct diagnosis and can expedite patient management. We report on the cytologic characteristics of enteropathy-associated intestinal T-cell lymphoma first detected in a cyst fluid specimen obtained from a patient with cavitating mesenteric lesions. Image-guided fine-needle aspiration resulted in chylous fluid that contained a lymphoid cell population with neoplastic morphology and abnormal immunophenotype. Further work-up led to the diagnosis of enteropathy-associated intestinal T-cell lymphoma with bone marrow involvement. Cytologic assessment of the cyst fluid is an important part of the diagnostic cascade in patients with CMLNS to exclude clinically occult lymphoma.
authors.affiliation: Laboratory Medicine Program, University Health Network, Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Joerg
authors.initials: J
authors.lastname: Schwock
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Hyjek
authors.forename: Emina E
authors.initials: EE
authors.lastname: Torlakovic
authors.forename: William R
authors.initials: WR
authors.lastname: Geddie
mesh_terms: D000368:Aged; D044963:Biopsy, Fine-Needle; D002446:Celiac Disease / Q000175:diagnosis / Q000473:pathology*; D002915:Chylous Ascites / Q000473:pathology; D058527:Enteropathy-Associated T-Cell Lymphoma / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008643:Mesentery / Q000473:pathology; D013577:Syndrome
keywords: cavitating mesenteric lymph node syndrome; celiac disease; cytology; enteropathy-associated intestinal T-cell lymphoma; fine-needle aspiration