Perforation of the small intestine caused by enteropathy-associated T cell lymphoma
Selva Kabul1
, Nesrin Uğraş1, Ömer Yerci1, Ersin Öztürk2
1Department of Surgical Pathology, Uludağ University School of Medicine, Bursa, Turkey
2Department of General Surgery, Uludağ University School of Medicine, Bursa, Turkey
Abstract
Enteropathy-associated T cell lymphoma is a rare lymphoma specific to the gastrointestinal system, arising from intraepithelial T lymphocytes, that is often associated with celiac disease. We report a 53-year-old female patient with no previous disease who presented with severe abdominal pain. Physical examination revealed diffuse abdominal tenderness and abdominal guarding and the patient underwent emergency surgery with a diagnosis of acute abdomen. During the operation, a 20-cm mass was found located on Treitz ligament, invading the duodenum and pancreatic head and perforating the jejunum. Histologically, medium-sized monomorphic atypical lymphocyte infiltration with dark nucleus and narrow cytoplasm was seen in the layers of mucosa, submucosa, muscular wall, and serosa of the duodenum. The final pathological diagnosis was “enteropathy-associated T cell lymphoma type 2” based on immunohistochemical and serological findings. Based on the World Health Organization 2008 criteria, enteropathy-associated T cell lymphoma has two subtypes. Type 1 enteropathy-associated T cell lymphoma is associated with celiac disease and has HLA DQ2 and HLA DQ8 genotype. Enteropathy-associated T cell lymphoma 2 enteropathy-associated T cell lymphoma seldom occurs and is not associated with celiac disease.
Keywords: Lymphoma, enteropathy, small intestine
Cite this paper as: Kabul S, Uğraş N, Yerci Ö, Öztürk E. Perforation of the small intestine caused by enteropathy-associated T cell lymphoma. Turk J Surg 2018; DOI: 10.5152/turkjsurg.2017.3278
Written informed consent was obtained from patient who participated in this study.
Externally peer-reviewed.
Concept - S.K.; Design - S.K., N.U.; Supervision - N.U., Ö.Y.; Resource - S.K., Ö.Y.; Materials - E.Ö., Ö.Y.; Data Collection and/or Processing - E.Ö., S.K.; Analysis and/or Interpretation - S.K., Ö.Y.; Literature Search - S.K., N.U., Ö.Y.; Writing Manuscript - S.K., N.U.; Critical Reviews - Ö.Y., E.Ö.,
The author have no conflicts of interest to declare.
The authors declared that this study has received no financial support.