title: Hepatosplenic T-cell lymphoma in a 47-year-old Crohn's disease patient on thiopurine monotherapy.
abstract: Hepatosplenic T-cell lymphoma (HSTCL) is a rare non-Hodgkin lymphoma with a high mortality rate. Higher incidence is reported in patients with inflammatory bowel disease, specifically in male patients that are younger than 35 years, and have been treated with thiopurine and tumor necrosis factor (TNF)-α inhibitor combination therapy for over 2 years. In this case report we describe a 47-year-old patient with Crohn's disease (CD) who developed HSTCL after having been treated with thiopurine monotherapy for 14 years. To our best knowledge, only eleven cases exist of patients with CD who developed HSTCL while on thiopurine monotherapy. We report the first patient with CD, older than 35 years, who developed HSTCL while on thiopurine monotherapy. This emphasizes that HSTCL risk is not limited to young men receiving both thiopurines and TNF-α inhibitors.
authors.affiliation: Maartje M van de Meeberg, Lauranne AAP Derikx, D Lucette Schipper, Loes HC Nissen, Department of Gastroenterology and Hepatology, Jeroen Bosch Hospital, 5200 ME 's-Hertogenbosch, The Netherlands.
authors.forename: Maartje M
authors.initials: MM
authors.lastname: van de Meeberg
authors.affiliation: Maartje M van de Meeberg, Lauranne AAP Derikx, D Lucette Schipper, Loes HC Nissen, Department of Gastroenterology and Hepatology, Jeroen Bosch Hospital, 5200 ME 's-Hertogenbosch, The Netherlands.
authors.forename: Lauranne A A P
authors.initials: LA
authors.lastname: Derikx
authors.affiliation: Maartje M van de Meeberg, Lauranne AAP Derikx, D Lucette Schipper, Loes HC Nissen, Department of Gastroenterology and Hepatology, Jeroen Bosch Hospital, 5200 ME 's-Hertogenbosch, The Netherlands.
authors.forename: Harm A M
authors.initials: HA
authors.lastname: Sinnige
authors.affiliation: Maartje M van de Meeberg, Lauranne AAP Derikx, D Lucette Schipper, Loes HC Nissen, Department of Gastroenterology and Hepatology, Jeroen Bosch Hospital, 5200 ME 's-Hertogenbosch, The Netherlands.
authors.forename: Peet
authors.initials: P
authors.lastname: Nooijen
authors.affiliation: Maartje M van de Meeberg, Lauranne AAP Derikx, D Lucette Schipper, Loes HC Nissen, Department of Gastroenterology and Hepatology, Jeroen Bosch Hospital, 5200 ME 's-Hertogenbosch, The Netherlands.
authors.forename: D Lucette
authors.initials: DL
authors.lastname: Schipper
authors.affiliation: Maartje M van de Meeberg, Lauranne AAP Derikx, D Lucette Schipper, Loes HC Nissen, Department of Gastroenterology and Hepatology, Jeroen Bosch Hospital, 5200 ME 's-Hertogenbosch, The Netherlands.
authors.forename: Loes H C
authors.initials: LH
authors.lastname: Nissen
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D001379:Azathioprine / Q000008:administration & dosage / Q000009:adverse effects*; D001706:Biopsy; D003424:Crohn Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D004334:Drug Administration Schedule; D017809:Fatal Outcome; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced; D006801:Humans; D016867:Immunocompromised Host; D007150:Immunohistochemistry; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D008113:Liver Neoplasms / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D016399:Lymphoma, T-Cell / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D008297:Male; D008875:Middle Aged; D052016:Mucositis / Q000139:chemically induced; D049268:Positron-Emission Tomography; D012307:Risk Factors; D013160:Splenic Neoplasms / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D013997:Time Factors
chemical_list: D007166:Immunosuppressive Agents; D001379:Azathioprine
keywords: Crohn’s disease; Hepatosplenic T-cell lymphoma; Immunosuppression; Thiopurine