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Enteropathy-associated T cell lymphoma with brain involvement

E L Berman1, N P Zauber, R R Rickert

  • 1Department of Pathology, Saint Barnabas Medical Center, Livingston, New Jersey 07039, USA.

Journal of Clinical Gastroenterology
|July 2, 1998
PubMed
Summary

Enteropathy-associated T cell lymphoma can spread to the brain, appearing as an inflammatory lesion. Molecular analysis is key to diagnosing this T cell lymphoma when it mimics inflammation.

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Area of Science:

  • Gastroenterology
  • Neurology
  • Oncology

Background:

  • Enteropathy-associated T cell lymphoma (EATL) is a rare gastrointestinal malignancy.
  • EATL can have diverse clinical presentations, sometimes mimicking inflammatory conditions.

Observation:

  • A patient presented with intestinal lesions characteristic of large cell lymphoma and a brain lesion initially appearing inflammatory.
  • The brain lesion showed necrosis and an infiltrate of histiocytes and lymphocytes, not typical of a primary brain tumor.

Findings:

  • Immunohistochemistry revealed lymphoma cells in the intestine and brain shared T cell markers and cytotoxic granules.
  • Molecular analysis demonstrated identical monoclonal rearrangement of the TCR-gamma gene in both intestinal and cerebral lesions.
  • These findings confirmed the brain lesion as a manifestation of disseminated EATL.

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Implications:

  • Disseminated EATL can present as an inflammatory brain lesion, posing a diagnostic challenge.
  • Immunophenotypic and molecular analyses are crucial for accurate diagnosis and differentiating neoplastic from inflammatory processes.
  • This case highlights the importance of considering systemic malignancy in unexplained neurological deficits.