ENTEROPATHY ASSOCIATED T-CELL LYMPHOMA – A RARE CAUSE OF ACUTE ABDOMEN

Dan Nicolae Păduraru; Daniel Ion; Alexandra Bolocan; Florentina Mușat; Cosmin Alexandru Palcău; Octavian Andronic

doi:10.33695/rojes.v3i1.39

Dan Nicolae Păduraru 1University Emergency Hospital of Bucharest, Romania 2Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Daniel Ion 1University Emergency Hospital of Bucharest, Romania 2Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Alexandra Bolocan 1University Emergency Hospital of Bucharest, Romania 2Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Florentina Mușat 1University Emergency Hospital of Bucharest, Romania 2Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Cosmin Alexandru Palcău 1University Emergency Hospital of Bucharest, Romania 2Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Octavian Andronic 1University Emergency Hospital of Bucharest, Romania 2Carol Davila University of Medicine and Pharmacy, Bucharest, Romania

DOI: https://doi.org/10.33695/rojes.v3i1.39

Keywords: EATL, non-Hodgkin lymphoma, jejunal tumor, acute abdomen

Abstract

Enteropathy associated T-cell lymphoma (EATL) is an extremely aggressive form of non- Hodgkin lymphoma. EATL is a rare form of peripheral lymphoma with a very poor prognosis and the five-year survival rate reported is between 11 and 20%. We present the case of a 33- years old male admitted for right iliac fossa pain and nausea. Blood test showed leukocytosis with neutrophilia. The conventional X-ray examination of the abdominal region showed a few “air-fluid” levels in the right flank and mesogastric area and the ultrasound found no particular alterations of the abdominal organs. These lead us to suspect an acute appendicitis and the patient was scheduled for emergency surgery. Intraoperative, we ascertain a perforated, stenotic jejunal tumor located at approximately 1 meter from the Treitz angle. A segmental enterectomy was performed with entero-enteral anastomosis end to end. The histopathological and immunohistochemistry examinations established the diagnosis of entheropathy associated T-cell lymphoma. The patient was discharged after a few days and started the proper adjuvant therapy. In most of the cases, the precise diagnosis is not facile, the patient usually presenting with intestinal haemorrhage, intestinal occlusion or perforation, the clinical presentation often misleading the medical team. EATL is usually a diagnosis of exclusion, other differential diagnoses being acute appendicitis, mechanical obstruction, intestinal bacterial infection and others.

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