Indolent T-cell lymphoproliferative disease (T-LPD) of gastrointestinal tract is a rare recently described disease that seldom progresses. We report a case of T-LPD with synchronous diffuse large B-cell lymphoma (DLBCL) that cause aggravation of disease.
A 46-year-old Chinese male presented with intermittent paraumbilical colic pain, bloating, and occasional diarrhea for 10 years. His condition aggravated with partial bowel obstruction recently. The patient was diagnosed as T-LPD initially based on histological result and T-cell receptor-gamma clonal gene rearrangement test. The patient was followed without chemotherapy. His condition stabilized for 1 year and then deteriorated with small intestine perforation.
The patient was diagnosed as indolent T-LPD and DLBCL finally.
The patient had surgery for intestine perforation and received chemotherapy for DLBCL and T-LPD afterward.
At 6 months follow-up, the patient continued to have resolution of his symptoms.
Early detection of high-grade transformation of T-LPD or the coexistence of aggressive lymphoma is essential for the patient. DLBCL may coexist in the indolent course of T-LPD. The diagnosis of T-LPD should be made cautiously in case with progressing symptoms such as intestinal obstruction.
aDepartment of Gastroenterology
bDepartment of Pathology, West China Hospital, Sichuan University, Chengdu, China
cDepartment of Pathology, The University of Chicago, Chicago, IL.
Correspondence: Yufang Wang, Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, P.R. China (e-mail: firstname.lastname@example.org).
Abbreviations: ANA = antinuclear antibodies, ANCA = antineutrophil cytoplasmic antibodies, CMV = cytomegalovirus, CTE = computed tomography enterography, DLBCL = diffuse large B-cell lymphoma, EATL = enteropathy associated T-cell lymphoma, EBV = Epstein Barr virus, HIV = human immunodeficiency virus, IBD = inflammatory bowel disease, PTCL = peripheral T cell lymphoma, TCR-γ = T-cell receptor-gamma, T-LPD = indolent T-cell lymphoproliferative disease.
Author ZW and LJG contributed equally to the article
This work was supported by the National Natural Science Foundation of China (no. 81270447).
The use of history records and clinical data was reviewed and approved by the ethics committee of the West China Hospital of Sichuan University (the ethical approval number 201983). Informed written consent was obtained from the patient for publication of this case report and accompanying images.
Find the patient and get the idea: ZW, YW.
Collect the information of the patient: LJG, ZW, YW.
Diagnosis and treatment for the patient: ZW, YW.
Write and revise the article: LJG, ZW, SX, XS, YW.
The authors have no conflicts of interest to disclose.
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Received October 21, 2018
Received in revised form March 12, 2019
Accepted March 25, 2019