Journal of Clinical and Experimental Hematopathology
Online ISSN : 1880-9952
Print ISSN : 1346-4280
ISSN-L : 1346-4280
Case Study
Enteropathy-Associated T-Cell Lymphoma Type II Complicated by Autoimmune Hemolytic Anemia
Aiko KatoYoko TakiuchiKazunari AokiYuichiro OnoHiroshi ArimaSeiji NaganoSumie TabataSoshi YanagitaAkiko MatsushitaHayato MaruokaMasaya WadaYukihiro ImaiTakayuki IshikawaTakayuki Takahashi
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2011 Volume 51 Issue 2 Pages 119-123

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Abstract

A 74-year-old man was admitted to hospital because of persistent fever, diarrhea, and abdominal pain. CT scanning showed extensive wall thickening of the colon. He was transferred to our hospital because he further developed ascites and paraaortic lymph node swelling. On presentation, he was extremely emaciated with superficial lymph node swelling, ascitic signs, and leg edema. Histological image of a biopsied mesenteric lymph node demonstrated diffuse infiltration of large abnormal T cells. Surface antigen analysis of abnormal cells in the ascites revealed positivity for CD3, CD8, CD56, and weak positivity for CD103. Polymerase chain reaction analysis showed monoclonal rearrangement of the T cell receptor (TCR) gene. The subtype of TCR was αβ. A diagnosis of enteropathy-associated T cell lymphoma (EATL) type II was made. The lymphoma involved the bone marrow. The patient also had severe hemolytic anemia with a positive Coomb's test result. An additional diagnosis for autoimmune hemolytic anemia (AIHA) was made, which was resistant to methylprednisolone therapy. We first treated him with only vincristine in addition to the steroid to avoid acute tumor lysis syndrome ; however, he died of septic shock that occurred soon after vincristine administration. To the best of our knowledge, this may be the first reported case of EATL complicated by AIHA. [J Clin Exp Hematopathol 51(2) : 119-123, 2011]

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© 2011 by The Japanese Society for Lymphoreticular Tissue Research
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