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

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.

Intestinal T-cell lymphomas NOS presenting as a polypoidal lesion: A case report

“…Yet those performance is often misdiagnosed as inflammatory bowel disease. [ 15 ] Eminence lesions frequently appear as single or multiple polypoid or nodular lesions with or without mucosal ulceration at the top. We report the patient found multiple polypoid lesions in the large intestine.…”

Intestinal T-cell lymphoma not otherwise specified: a case report and literature review

“…The final diagnosis of ITCL, NOS was rendered by immunohistochemistry, which showed positivity for CD3, CD4, CD8, CD103 and negativity for CD20, CD5 and CD56. The patient received CHOP (cyclophosphamide, doxorubicin hydrochloride [hydroxydaunorubicin], vincristine sulfate [Oncovin ® ], and prednisone) with improvement and no significant adverse out comes were reported after the treatment was started [ 12 ].…”

Classification and challenges in the histopathological diagnosis of peripheral T-cell lymphomas, emphasis on the WHO-HAEM5 updates

“…EATL is an aggressive disease predominantly composed of CD8+ T-cells with the expression of TCR-α/β ( 21 , 22 ). Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is more frequent in Asia and is composed of medium-sized lymphocytes with a homogeneous appearance, epitheliotropism, and frequent expression of CD56 ( 23 – 27 ) ( Figure 2 ). The category of intestinal T-cell lymphomas non-otherwise specified (ITCL-NOS) remains as an entity that fails classification with the current schemes ( Table 3 ; Figure 3 ), with very few case reports available ( 28 – 30 ).…”