Monomorphic epitheliotropic intestinal T-cell lymphoma presenting as melena with long-term survival: A case report and review of literature |
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Authors: | Sotaro Ozaka Kunimitsu Inoue Tomoya Okajima Takako Tasaki Shimpei Ariki Hideki Ono Takeaki Ando Tsutomu Daa Kazunari Murakami |
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Affiliation: | Sotaro Ozaka, Shimpei Ariki, Kazunari Murakami, Department of Gastroenterology, Faculty of Medicine, Oita University, Oita 879-5593, JapanKunimitsu Inoue, Tomoya Okajima, Takako Tasaki, Hideki Ono, Department of Gastroenterology, Almeida Memorial Hospital, Oita 870-1195, JapanTakeaki Ando, Department of Hematology, Almeida Memorial Hospital, Oita 870-1195, JapanTsutomu Daa, Department of Diagnostic Pathology, Oita University, Oita 879-5593, Japan |
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Abstract: | BACKGROUNDMonomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is a rare primary intestinal T-cell lymphoma, previously known as enteropathy-associated T-cell lymphoma type II. MEITL is an aggressive T-cell lymphoma with a poor prognosis and high mortality rate. The known major complications of MEITL are intestinal perforation and obstruction. Here, we present a case of MEITL that was diagnosed following upper gastrointestinal bleeding from an ulcerative duodenal lesion, with recurrence-free survival for 5 years.CASE SUMMARYA 68-year-old female was admitted to our hospital with melena and mild anemia. An urgent esophagogastroduodenoscopy (EGD) revealed bleeding from an ulcerative lesion in the transverse part of the duodenum, for which hemostatic treatment was performed. MEITL was diagnosed following repeated biopsies of the lesion, and cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy was administered. She achieved complete remission after eight full cycles of CHOP therapy. At the last follow-up examination, EGD revealed a scarred ulcer and 18Fluorodeoxyglucose (18FDG) positron emission tomography/computed tomography showed no abnormal FDG accumulation. The patient has been in complete remission for 68 mo after initial diagnosis.CONCLUSIONTo rule out MEITL, it is important to carefully perform histological examination when bleeding from a duodenal ulcer is observed. |
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Keywords: | Monomorphic epitheliotropic intestinal T-cell lymphoma Enteropathy-associated T-cell lymphoma type II Gastrointestinal bleeding Intestinal lymphoma Duodenal ulcer Case report |
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