Difficulties in diagnosing intestinal T-cell lymphoma. Case report

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Abstract

The article describes a rare diagnosis of monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL), due to its veiled by a number of so-called “masks” of enteropathies. A detailed analysis of all clinical, morphological and immunohistochemical data made it possible to establish the correct diagnosis. The revealed pathology is extremely rare in practice, even among specialists in hematology. The article demonstrates the main stages of both a complex diagnosis and an attempt at therapy for this aggressive form of intestinal lymphoma.

About the authors

Igor Yu. Gadaev

Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: doktor-gai@yandex.ru
ORCID iD: 0000-0002-2782-4179

канд. мед. наук, доц., доц. каф. госпитальной терапии №1 Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

Vladimir I. Ershov

Sechenov First Moscow State Medical University (Sechenov University)

Email: doktor-gai@yandex.ru
ORCID iD: 0000-0002-8641-1489

д-р мед. наук, проф. каф. госпитальной терапии №1 Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

Alla M. Kovrigina

National Medical Research Center for Hematology

Email: doktor-gai@yandex.ru
ORCID iD: 0000-0002-1082-8659

д-р биол. наук, проф., зав. отд. патологической анатомии

Russian Federation, Moscow

Irina Ya. Sokolova

Sechenov First Moscow State Medical University (Sechenov University)

Email: doktor-gai@yandex.ru
ORCID iD: 0000-0002-8884-1087

врач-гематолог высш. категории гематологического отд. клиники Госпитальной терапии им. А.А. Остроумова УКБ №1 Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

Olga V. Tashyan

Sechenov First Moscow State Medical University (Sechenov University)

Email: doktor-gai@yandex.ru
ORCID iD: 0000-0001-6759-6820

канд. мед. наук, ассистент каф. госпитальной терапии №1 Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

Marat A. Mingalimov

Sechenov First Moscow State Medical University (Sechenov University)

Email: doktor-gai@yandex.ru
ORCID iD: 0000-0002-8491-2140

клинический ординатор каф. госпитальной терапии №1 Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

Olga N. Antyufeeva

Sechenov First Moscow State Medical University (Sechenov University)

Email: doktor-gai@yandex.ru
ORCID iD: 0000-0003-4268-3076

врач-гематолог гематологического отд. клиники Госпитальной терапии им. А.А. Остроумова УКБ №1, ассистент каф. госпитальной терапии №1 Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

Darya A. Budanova

Sechenov First Moscow State Medical University (Sechenov University)

Email: doktor-gai@yandex.ru
ORCID iD: 0000-0001-6324-2371

канд. мед. наук, врач-гематолог гематологического отд. клиники Госпитальной терапии им. А.А. Остроумова УКБ №1 Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

Marina G. Mnatsakanyan

Sechenov First Moscow State Medical University (Sechenov University)

Email: doktor-gai@yandex.ru
ORCID iD: 0000-0001-9337-7453

д-р мед. наук, проф. каф. госпитальной терапии №1 Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

Olga V. Bochkarnikova

Sechenov First Moscow State Medical University (Sechenov University)

Email: doktor-gai@yandex.ru
ORCID iD: 0000-0001-9316-6920

зав. гематологическим отд. клиники Госпитальной терапии им. А.А. Остроумова УКБ №1 Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

Daria S. Nagornaia

Sechenov First Moscow State Medical University (Sechenov University)

Email: doktor-gai@yandex.ru
ORCID iD: 0000-0002-2490-6371

клинический ординатор каф. госпитальной терапии №1 Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

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2. Fig. 1. Colon mucosal biopsy specimen. In lamina propria, a monomorphic lymphoid infiltrate of small/medium-sized lymphoid cells, predominantly with round-oval nuclei, is observed. Hematoxylin and eosin staining. 200× magnification.

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3. Fig. 2. Colon mucosal biopsy specimen. Immunohistochemical examination. Tumor cell expression of TCR (bF1), enzyme immunoassay. 200× magnification.

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4. Fig. 3. Colon mucosal biopsy specimen. Immunohistochemical examination. Tumor cell expression of CD8, enzyme immunoassay. 200× magnification.

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5. Fig. 4. Colon mucosal biopsy specimen. Immunohistochemical examination. Tumor cell expression of TIA-1, enzyme immunoassay. 200× magnification.

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6. Fig. 5. Colon mucosal biopsy specimen. Immunohistochemical examination. Tumor cell expression of CD30, enzyme immunoassay. 200× magnification.

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7. Fig. 6. Colon mucosal biopsy specimen. Immunohistochemical examination. The proliferative activity index of Ki-67 is up to 60% of positive tumor substrate cells. Enzyme immunoassay. 200× magnification.

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Copyright (c) 2023 Gadaev I.Y., Ershov V.I., Kovrigina A.M., Sokolova I.Y., Tashyan O.V., Mingalimov M.A., Antyufeeva O.N., Budanova D.A., Mnatsakanyan M.G., Bochkarnikova O.V., Nagornaia D.S.

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This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 
 


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