Successful early diagnosis of monomorphic epitheliotropic intestinal T-cell lymphoma manifesting as chronic diarrhea and hypokalemia using video capsule endoscopy and double-balloon enteroscopy.
Successful early diagnosis of monomorphic epitheliotropic intestinal T-cell lymphoma manifesting as chronic diarrhea and hypokalemia using video capsule endoscopy and double-balloon enteroscopy.
复制标题
使用视频胶囊内窥镜和双气囊肠镜成功早期诊断表现为慢性腹泻和低钾血症的单形性上皮性肠道 T 细胞淋巴瘤。
DOI：
10.1007/s12328-022-01676-8
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Nakamoto Y.
中科院分区：
文献类型：
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作者：
Naito T;Nosaka T;Takahashi K;Ofuji K;Matsuda H;Ohtani M;Hiramatsu K;Imamura Y;Yamauchi T;Nakamoto Y.
单形性肠嗜上皮性T细胞淋巴瘤（MEITL），以前称为肠病相关T细胞淋巴瘤（EATL）II型，是一种罕见的疾病，预后不良，通常在患者出现肠穿孔或肠梗阻时诊断。我们的病人是一位60多岁的男性，有持续性水样腹泻5个月的病史.上消化道和下消化道内镜检查、腹部计算机断层扫描（CT）和粪便培养结果均无异常。8个月后，患者因体重减轻20 kg、全身乏力和低钾血症入院。腹部增强CT显示小肠壁轻度增厚和增强。进行了视频胶囊式内窥镜和双气囊小肠镜检查，以显示空肠中的广泛溃疡和整个小肠的多处糜烂。活检标本的检查显示腺上皮中有非典型淋巴细胞浸润，胞浆苍白。非典型淋巴细胞的免疫组化染色显示CD 3、CD 8、CD 56、颗粒酶B和T细胞胞内抗原1阳性。MEITL得到早期诊断，患者通过持续化疗存活了21个月。小肠的积极检查是有效的早期诊断严重疾病，如MEITL，在慢性腹泻患者的原因不明。
Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL), formerly known as enteropathy-associated T-cell lymphoma (EATL) type II, is a rare disease with a poor prognosis that is often diagnosed when patients present with intestinal perforation or obstruction. Our patient, a man in his 60 s, had a 5-month history of persistent watery diarrhea. Upper and lower gastrointestinal endoscopy, abdominal computed tomography (CT), and stool culture results were unremarkable. He was admitted to our hospital 8 months later with a weight loss of 20 kg, general fatigue, and hypokalemia. Contrast-enhanced CT of the abdomen revealed mild thickening and contrast enhancement of the small intestinal wall. Video capsule endoscopy and double-balloon enteroscopy were performed to reveal a broad ulcer in the jejunum and multiple erosions throughout the small intestine. Examination of the biopsy specimens showed infiltration of atypical lymphocytes with pale cytoplasm in the glandular epithelium. The atypical lymphocytes were positive for CD3, CD8, CD56, granzyme B, and T-cell intracellular antigen-1 by immunostaining. Early diagnosis of MEITL was made, and the patient survived for 21 months with continuous chemotherapy. Aggressive examination of the small intestine is effective for the early diagnosis of serious diseases, such as MEITL, in patients with chronic diarrhea of unknown origin.