A 74-year-old woman with abdominal distension and melena underwent computed tomography (CT), which showed a 3×3-cm mass in her small intestine. A lower endoscopic biopsy of the mass revealed a monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL). The tumor was completely resected (Picture 1, 2); however, CT performed a month later indicated new tumors in the operated area. On receiving one cycle of CHOP (cyclophosphamide, adriamycin, vincristine, and prednisolone) and two cycles of ESHAP (ifosfamide, cisplatin, etoposide, methylprednisolone, and cytarabine), a partial response was achieved. However, she developed paralysis in her legs, and CT revealed cerebral hemorrhaging. She ultimately died, and during her autopsy, edema was found in her left cerebral hemisphere in addition to invasion of lymphoma and cerebral hemorrhaging (Picture 3, 4). A few case reports have suggested that MEITL might invade the brain; however, this is the first report that directly proves MEITL brain involvement through an autopsy.
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Author's disclosure of potential Conflicts of Interest (COI).
Mineo Kurokawa: Honoraria, Takeda Pharmaceutical.