Abstract
We report a case of enteropathy-type T-cell lymphoma recurring as a small intestine perforation after a remission of chemotherapy. A 64-year-old man with massive melena was referred to our hospital in November 2008. We performed emergency laparotomy and partial jejunectomy. Immunohistological examination demonstrated malignant lymphoma, NK/T-cell phenotype (CD3+, CD56+). After small bowel resection, he started to receive the CHOP regimen (cyclophosphamide, doxorubicin, vincristine and prednisolone) and achieved complete remission. However, he was admitted again with abdominal pain in February 2010. Computed tomography showed free air and ascites in the abdomen. Emergency laparotomy was performed after a diagnosis of small intestine perforation. During surgery we found a jejunal rupture, so we excised a part of the jejunum at this site. Immunohistologically, T-cell lymphoma was revealed again. Subsequent ileal rupture following jejunal rupture occurred, and the patient died of disseminated intravascular coagulation (DIC) after re-operation. The prognosis of enteropathy-type T-cell lymphoma is very poor, and it is a disease which should be given careful consideration.
