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Intestinal T-Cell Lymphoma With Lung and Lymph Node Involvement at Relapse
Yasuhiro Tanaka1, Tatsuzo Mishina2, Hiroaki Miyoshi2
1Department of Hematology, Japanese Red Cross Wakayama Medical Center, Komatsubaradori 4-20, Wakayama City, Wakayama 640-8558, Japan.
Journal of Medical Cases
|February 25, 2022
Summary
Intestinal T-cell lymphomas (ITLs) rarely involve the lungs. This case highlights the importance of biopsy for pulmonary findings in ITL patients and suggests gemcitabine, dexamethasone, and cisplatin chemotherapy as a salvage option.
Area of Science:
- Oncology
- Gastroenterology
- Pulmonology
Background:
- Intestinal T-cell lymphomas (ITLs) typically present with gastrointestinal perforation.
- Extranodal involvement is common in advanced or relapsed ITLs, but lung involvement is rare.
Observation:
- A 76-year-old male with ITL, not otherwise specified (NOS), presented with colon perforation.
- Following chemotherapy, he developed pulmonary infiltration and lymphadenopathy, confirmed as relapsed ITL.
- Despite further chemotherapy, the patient experienced disease progression and died.
Findings:
- This is the third reported case of ITL with biopsy-proven lung involvement.
- Pulmonary nodules, infiltration, or ground-glass opacity in ITL patients warrant active biopsy.
- Gemcitabine, dexamethasone, and cisplatin (GDP) chemotherapy showed activity in this relapsed ITL case.
Implications:
- Early diagnosis and biopsy are crucial for managing rare pulmonary manifestations of ITLs.
- GDP chemotherapy may serve as a salvage regimen for relapsed ITLs.
- Further research into novel agents like romidepsin and pralatrexate is needed for ITL treatment.
