Journal of Gastroenterology

, Volume 34, Issue 2, pp 253–259

Immunoblastic lymphadenopathy-like T-cell lymphoma complicated by multiple gastrointestinal involvement

  • Toshimichi Kaneki
  • Akira Kawashima
  • Taiji Akamatsu
  • Naoki Tanaka
  • Keishi Kubo
  • Tomonobu Koizumi
  • Morie Sekiguchi
  • Noriko Hosaka
  • Takayuki Honda
  • Shoichiro Koike
  • Wataru Adachi

DOI: 10.1007/s005350050253

Cite this article as:
Kaneki, T., Kawashima, A., Akamatsu, T. et al. J Gastroenterol (1999) 34: 253. doi:10.1007/s005350050253

Abstract:

We report a rare case of immunoblastic lymphadenopathy (IBL)-like T-cell lymphoma complicated by multiple gastrointestinal involvement, which appeared to be ameliorated by chemotherapy but resulted in perforative peritonitis. A 66-year-old Japanese woman who had generalized lymphadenopathy and eruptions was admitted to our hospital because of bloody stool. Colonoscopic examination revealed hemorrhagic ulcers in the terminal ileum and a saucer-like ulcer in the cecum. Gastrointestinal endoscopy revealed several ulcerative or elevated lesions in stomach and duodenum. Biopsy specimens of these lesions and of a lymph node showed characteristic histological features of IBL-like T-cell lymphoma. The initial treatment with prednisolone (PSL) and cyclophosphamide (CPA) was effective. Six months after the treatment, however, she developed bloody stool again caused by multiple ulcerative lesions in the large intestine. The recurrence of the disease was determined histologically, and four courses of CPA, PSL, vinblastine sulfate and doxorubicin hydrochloride (CHOP) therapy were administered. One month after completing the CHOP therapy, she developed intestinal obstruction and then acute peritonitis resulting from perforation at an ulcer scar in the jejunum. Surgical treatment was successful, and histological examination demonstrated no lymphoma cells in the resected specimen. A gastrointestinal perforation should be recognized as a potential complication of IBL-like T-cell lymphoma, even during remission.

Key words: immunoblastic lymphadenopathy-like T-cell lymphomagastrointestinal involvementperipheral T-cell lymphomagene rearrangementperforative peritonitis

Copyright information

© Springer-Verlag Tokyo 1999

Authors and Affiliations

  • Toshimichi Kaneki
    • 1
  • Akira Kawashima
    • 1
  • Taiji Akamatsu
    • 2
  • Naoki Tanaka
    • 3
  • Keishi Kubo
    • 1
  • Tomonobu Koizumi
    • 1
  • Morie Sekiguchi
    • 1
  • Noriko Hosaka
    • 4
  • Takayuki Honda
    • 4
  • Shoichiro Koike
    • 5
  • Wataru Adachi
    • 5
  1. 1.First Department of Internal Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, JapanJP
  2. 2.Department of Endoscopy, Shinshu University School of Medicine, Matsumoto, JapanJP
  3. 3.Second Department of Internal Medicine Shinshu University School of Medicine, Matsumoto, JapanJP
  4. 4.Department of Laboratory Medicine Shinshu University School of Medicine, Matsumoto, JapanJP
  5. 5.Second Department of Surgery Shinshu University School of Medicine, Matsumoto, JapanJP