INTESTINE Vol.19 No.3(2-5)

Theme Intestinal malignant lymphoma
Title Diagnosis and treatment of intestinal T cell lymphoma
Publish Date 2015/05
Author Noritaka Takatsu Department of Gastroenterology, Fukuoka University Chikushi Hospital
Author Toshiyuki Matsui Department of Gastroenterology, Fukuoka University Chikushi Hospital
Author Kentaro Imamura Department of Pathology, Fukuoka University Chikushi Hospital
Author Akinori Iwashita Department of Pathology, Fukuoka University Chikushi Hospital
[ Summary ] Enteropathy-associated T-cell lymphoma (EATL) is a primary extranodal T-cell lymphoma arising in the intestine originating from intraepithelial T cells. EATL most commonly affects the jejunum and ileum. Approximately 40 % of patients seek care because of an acute abdomen owing to intestinal obstruction and/or perforation caused by a tumor, with acute peritonitis requiring an emergency surgical procedure. Septicemia due to acute peritonitis accounts for the dismal clinical prognosis in these cases.
Recently, some cases of EATL have been reported, in which early diagnosis was made possible by an endoscopic modality such as double-balloon enteroscopy and/or capsule endoscopy. For the optimal treatment of EATL, it is important to diagnose the disease at an early stage, by using these endoscopic modalities.
Systemic adult T-cell leukemia/lymphoma (ATLL), caused by the human T-lymphotropic virus type 1 (HTLV-1), often presents with secondary involvement of the gastrointestinal tract primary gastrointestinal T-cell lymphoma associated with HTLV-1 is rare. Systemic ATLL leads to various lesions in the gastrointestinal tract.
Patients with acute or lymphomatous-type ATLL have extremely poor prognosis, mainly because of resistance to conventional chemotherapies. Recently, allogeneic hematopoietic stem cell transplantation (HSCT) and a humanized anti-CCR4 monoclonal antibody have been explored as promising alternatives that can provide long-term remission in a subset of patients with ATLL.
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