A report of a case ; monomorphic epitheliotropic intestinal T-cell lymphoma that perforated intraoperatively because of its extremely fragility

極めて脆弱で術中に破綻した単形性上皮向性腸管T細胞リンパ腫の1例

A report of a case ; monomorphic epitheliotropic intestinal T-cell lymphoma that perforated intraoperatively because of its extremely fragility

Creators Kawamura Daichi

Creators Hirata Ken

Creators Orita Masahiko

単形性上皮向性腸管T細胞リンパ腫(monomorphic epitheliotropic intestinal T-cell lymphoma

We report a case of Monomorphic epitheliotropic intestinal T-cell lymphoma(MEITL),a rare malignant lymphoma that is prone to perforation and intestinal obstruction and has a poor prognosis. A 76-year-old man was referred to our hospital from the clinic because of continuing fever, vomiting, and diarrhea diagnosed as enteritis. At our hospital, he was diagnosed as enteritis again from the abdominal CT scan that has showed localized thickening of the small intestinal wall. About one month later of conservative treatment, he had severe abdominal pain and bowel obstruction, and admitted to our hospital urgently. PET-CT scan showed accumulation of FDG in the thickened intestinal wall, suggesting malignant lymphoma. After the further examination, the planned surgery was performed under the laparotomy. The tumor was extremely fragile, and the tumor perforated very easily just by grasping it. The tumor and its mesentery were resected. Postoperative course was good, and he was discharged 11 days after surgery. The tumor was finally diagnosed as MEITL by the pathological examination of surgical specimen. Although the chemotherapy was sequentially performed, the peritonitis carcinomatosa was developed 6 months after the operation. From the cytology of ascites, the MEITL recurrence was diagnosed. He died 7 months after the operation.