CD30 + Primary intestinal T-cell lymphoma (unclassified) masquerading as chronic inflammation: a case report

Diagn Pathol. 2022 Jun 25;17(1):53. doi: 10.1186/s13000-022-01237-0.

Abstract

Background: Primary intestinal T-cell lymphomas are uncommon malignancies that pose a diagnostic dilemma, because the clinical features and imaging findings commonly overlap with those encountered in inflammatory bowel diseases.

Case presentation: The current clinical case report describes the clinical history, laboratory findings and histopathological analysis from a patient with non-specific gastrointestinal symptoms with a presumptive clinical diagnosis of inflammatory bowel disease, and two intestinal biopsy specimens with non-specific findings. Due to the persistent symptoms a third biopsy was consistent with primary intestinal T-cell lymphoma, a diagnosis that was elusive for months after the initial presentation. Clinical correlation with laboratory and histopathological findings is required to establish a definitive diagnosis and to further stratify the patients. In addition, the neoplastic cells featured partial expression of CD30, which had relevant therapeutic implications.

Conclusions: Suspicion for an intestinal T-cell lymphoproliferative disorder should always exist in patients with persistent abdominal symptoms with no clear etiology. The current discussion provides a summary and review of the key diagnostic histological features for the classification of primary intestinal T-cell lymphomas. In addition, the discussion describes how specific the histological findings are relevant for the clinical management decisions.

Keywords: Case report28; Primary intestinal; T-cell lymphoma; T-cell lymphoma NOS.

Publication types

  • Case Reports

MeSH terms

  • Enteropathy-Associated T-Cell Lymphoma* / diagnosis
  • Enteropathy-Associated T-Cell Lymphoma* / pathology
  • Humans
  • Inflammation / pathology
  • Ki-1 Antigen
  • Lymphoproliferative Disorders* / pathology
  • T-Lymphocytes / pathology

Substances

  • Ki-1 Antigen