Abstract
A 65-year-old man who was seen at the department of internal medicine in our hospital because of abdominal pain and vomiting was found having wall thickening of the small bowel, dilatation of the bowel proximal to the thickened portion, and multiple swollen lymph nodes of the mesentery by an abdominal CT scan. Small bowel endoscopy revealed a tumor lesion at the jejunum, a biopsy for which was done. Histopathological studies showed proliferation of atypical lymphocytes. Immunohistohemical staining of the tumor cells revealed CD3(+), CD4(-), CD8(+), CD20(-), and CD56(+). From these findings, enteropathy associated T-cell lymphoma (EATL) was diagnosed. Following eight courses of CHOP therapy, the tumor remnant was identified, so that six courses of DeVIC therapy were added. Small bowel endoscopy for evaluation disclosed the tumor remnant and serious degree of bowel stricture. Partial resection of the small intestine was performed. Since around three months after the operation, suprapubic pain developed. Close examination suggested recurrence of sigmoid colon lymphoma, and Hartmann operation was performed. We added two courses of SMILE therapy after the second operation, but the therapeutic outcome was rated NC. The patient is now on chemotherapy mainly with gemcitabine.
This paper deals with a case of EATL, which is a rare type malignant lymphoma, performed twice resections with a review of the literature.
