A case of colon perforation due to enteropathy-associated T-cell lymphoma

World J Gastroenterol. 2013 Mar 21;19(11):1841-4. doi: 10.3748/wjg.v19.i11.1841.

Abstract

Enteropathy-associated T-cell lymphoma (EATL) is an extremely rare disease, which is often related to gluten-sensitive enteropathy. It is an uncommon intestinal lymphoma with very poor prognosis and high mortality rate. In the absence of specific symptoms or radiological findings, it is difficult to diagnose early. Major complications of EATL have been known as intestinal perforation or obstruction, and only 5 cases of EATL are reported in South Korea. In this study, we report a case of 71-year-old male with symptoms of diarrhea, which later it progressed into cancer perforation of the colon. The initial colonoscopic findings were normal and computed tomography scan demonstrated a segmental wall thickening of the distal ascending colon with nonspecific multiple small lymphnodes, along the ileocolic vessels, but no signs of mass or obstruction. The histologic findings of resected specimen confirmed EATL type II. Patient expired two weeks after the operation. Therefore, we emphasize the need of random biopsy in the presence of normal mucosa appearance on colonoscopy for the early diagnosis of EATL.

Keywords: Celiac disease; Enteropathy-associated T-cell lymphoma type II; Gastrointestinal lymphoma; Intestinal perforation.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Biopsy
  • Colectomy
  • Colon / diagnostic imaging
  • Colon / pathology*
  • Colon / surgery
  • Colonic Diseases / etiology*
  • Colonic Diseases / pathology
  • Colonic Diseases / surgery
  • Colonoscopy
  • Enteropathy-Associated T-Cell Lymphoma / complications*
  • Enteropathy-Associated T-Cell Lymphoma / pathology
  • Enteropathy-Associated T-Cell Lymphoma / surgery
  • Fatal Outcome
  • Humans
  • Intestinal Perforation / etiology*
  • Intestinal Perforation / pathology
  • Intestinal Perforation / surgery
  • Male
  • Predictive Value of Tests
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome