Case Report
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World J Gastroenterol. Mar 21, 2013; 19(11): 1841-1844
Published online Mar 21, 2013. doi: 10.3748/wjg.v19.i11.1841
A case of colon perforation due to enteropathy-associated T-cell lymphoma
Jun Bong Kim, Seong Hwan Kim, Young Kwan Cho, Sang Bong Ahn, Yun Ju Jo, Young Sook Park, Ji Hyun Lee, Dong Hee Kim, Hojung Lee, Yun Young Jung
Jun Bong Kim, Seong Hwan Kim, Young Kwan Cho, Sang Bong Ahn, Yun Ju Jo, Young Sook Park, Ji Hyun Lee, Department of Internal Medicine, Eulji Medical Center, Eulji University, Seoul 139-711, South Korea
Dong Hee Kim, Department of Surgery, Eulji Hospital, Eulji Medical Center, Seoul 139-711, South Korea
Hojung Lee, Department of Pathology, Eulji Hospital, Eulji Medical Center, Seoul 139-711, South Korea
Yun Young Jung, Department of Radiology, Eulji Hospital, Eulji Medical Center, Seoul 139-711, South Korea
Author contributions: Kim JB and Kim SH contributed equally to this work; Cho YK and Ahn SB conceived and designed the study; Jo YJ, Park YS and Lee JH assisted in the research and revision of the paper; Kim DH performed operation; Lee H performed histologic and pathologic examination; Jung YY evaluated imaging studies; Kim JB and Kim SH wrote the paper; all of the authors have read and approved the final manuscript.
Correspondence to: Seong Hwan Kim, MD, PhD, Department of Internal Medicine, Eulji Medical Center, Eulji University, Seoul 139-711, South Korea. shkim@eulji.ac.kr
Telephone: +82-2-9708297 Fax: +82-2-9728621
Received: July 23, 2012
Revised: September 4, 2012
Accepted: November 14, 2012
Published online: March 21, 2013
Abstract

Enteropathy-associated T-cell lymphoma (EATL) is an extremely rare disease, which is often related to gluten-sensitive enteropathy. It is an uncommon intestinal lymphoma with very poor prognosis and high mortality rate. In the absence of specific symptoms or radiological findings, it is difficult to diagnose early. Major complications of EATL have been known as intestinal perforation or obstruction, and only 5 cases of EATL are reported in South Korea. In this study, we report a case of 71-year-old male with symptoms of diarrhea, which later it progressed into cancer perforation of the colon. The initial colonoscopic findings were normal and computed tomography scan demonstrated a segmental wall thickening of the distal ascending colon with nonspecific multiple small lymphnodes, along the ileocolic vessels, but no signs of mass or obstruction. The histologic findings of resected specimen confirmed EATL type II. Patient expired two weeks after the operation. Therefore, we emphasize the need of random biopsy in the presence of normal mucosa appearance on colonoscopy for the early diagnosis of EATL.

Keywords: Enteropathy-associated T-cell lymphoma type II, Intestinal perforation, Gastrointestinal lymphoma, Celiac disease