Various Endoscopic Features in Monomorphic Epitheliotropic Intestinal T-Cell Lymphoma

Area of Science:

• Gastroenterology
• Oncology
• Pathology

Background:

• Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is an aggressive non-Hodgkin lymphoma.
• Accurate diagnosis often requires a combination of imaging, endoscopy, and histopathology.

Observation:

• A 77-year-old female presented with acute severe abdominal pain.
• CT scans revealed jejunum and ileum wall thickening with surrounding fatty deposits.
• Single balloon endoscopy showed edema, erythema, erosions, and ulcers in the small intestine.

Findings:

• Histology confirmed intraepithelial lymphocytosis with atypical lymphocytes.
• Immunohistochemistry revealed a CD3+, CD7+, CD56+, CD4-, CD5-, CD8- T-cell phenotype.
• PET-CT demonstrated widespread disease involvement including small intestine, lymph nodes, and bone.

Implications:

• This case highlights the utility of single balloon endoscopy in visualizing MEITL.
• Early endoscopic detection and characteristic histological findings are crucial for diagnosing MEITL.
• Chemotherapy demonstrated efficacy, with the patient surviving 1 year post-diagnosis.