Monomorphic epitheliotropic intestinal T lymphoma

Reporte de Caso

Abstract

Introduction: Monomorphic epitheliotropic intestinal T-cell lymphoma is a derived neoplasia of intraepithelial lymphocytes. The etiology is unknown, but it has been associated with celiac disease or malabsorption syndrome, although it is currently considered a sporadic lymphoma. Histopathology is characterized by medium to small lymphocytes with minimal pleo-morphism, which generally express CD8 and CD56.

Case report: A 60-year-old woman with long-standing dyspepsia, admitted for acute abdominal pain, diarrhea, nausea, bilious vomiting, and weight loss. In the studies, hypochromic microcytic anemia and fluid and electrolyte imbalance were determined. A splenic nodular lesion and segmental concentric thickening of the jejunum and distal ileum associated with the presence of free fluid in the abdominal cavity was evidenced by abdominal tomography.

Evolution: An exploratory laparotomy was performed with resection of the jejunum-transverse anastomosis latero-lateral, in pathology the presence of 3 tumors was detected: at the jejunum level of 16x8.5x6 cm, in the distal ileum of 13x6.5x3 cm and in the 5x4x2cm cecum with histology of high-grade non-Ho-dgkin T lymphoma, primary intestinal, epitheliotropic monomorphic type (MEITL). She was discharged in better condition ten days later. Two weeks after discharge, development of urinary focus sepsis, dehydration due to short bowel syndrome, hyperammonemia and multiple focus pneumonia with bilateral pleural effusion. He died on the sixth day of hospitalization.

Conclusions: In conclusion, MEITL is a recently identified aggressive primary intestinal neoplasm and poor prognosis. The molecular and genetic mechanisms associated with this entity are not fully known. The case presented showed a clinical course similar to that reported in the literature.