Enteropathy-associated T-cell lymphoma

Overview

Enteropathy-Associated T-cell Lymphoma (EATL) is a T-cell lymphoma of the small intestine. It is the most common primary gastrointestinal T-cell lymphoma, arising from the T cells that are found between the cells that line the small intestinal (brush border cells or small intestinal epithelial cells). These cancerous T-cells are a consequence of prolonged, untreated coeliac disease in genetically susceptible individuals.

Symptoms

* Cillous atrophy * Crypt hyperplasia * Lymphomatous nodules

Diagnosis

In 25 of the 31 patients, the diagnosis of enteropathy-type intestinal T-cell lymphoma was made at laparotomy. In 13 patients, surgery was performed as an emergency: in four because of severe abdominal pain, in five because of features of bowel obstruction, and in four because of peritonism. The remaining six patients were diagnosed from barium studies together with small-bowel biopsies. Surgical procedures included small-bowel resection with or without mesenteric nodal and liver biopsies. At diagnosis, lymphoma was found in a single site within the small bowel in 21 patients and at multiple small-bowel locations in 10. Enlarged mesenteric nodes were histologically infiltrated with lymphoma in 11 patients, the omentum was affected in two, the liver was affected in two, mesentery was affected in one, and colon (contiguous with small bowel) was affected in one.