Abstract
A 69-year-old man was admitted to our hospital for left abdominal pain. Abdominal computed tomography (CT) revealed wall thickening and an ischemic change in the jejunum. With a diagnosis of ischemic enteritis, we applied conservative therapy, but follow-up CT showed deterioration of the ischemic change and swelling of the lymph nodes. Endoscopy revealed ulcerated lesions of the ascending portion of the duodenum and the jejunum. Biopsy study showed diffuse invasion of small, atypical lymphocytes that were CD3+, CD8+, CD20-, and CD56+ on immunohistochemistry. From these findings, enteropathy-associated T cell lymphoma (EATL) type II was diagnosed. An operation was performed first because the tumor had a risk of perforation. Tumor invasion of the submucosal layer was evident, and multiple tumors were palpable until the terminal ileum. The horizontal and ascending portions of the duodenum and jejunum were resected. A THP-COP regimen was applied postoperatively, but the patient died 3 months after surgery.
