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Gastrointestinal: Endoscopic findings of monomorphic epitheliotropic intestinal T‐cell lymphoma

A 64-year-old man without any previous history came to our hospital with diarrhea present over several months prior to presentation. Blood test revealed hypoalbuminemia. Esophagogastroduodenoscopy showed mildly atrophic mucosal change of the stomach. Colonoscopy showed only several diverticulum. Random duodenum and colonic biopsies were unremarkable. Capsule endoscopy revealed hyperemic mucosa with villous atrophy and mild erosions (Fig. 1). Double-balloon enteroscopy showed an edematous mucosa with a mosaic pattern and multiple shallow geographical jejunum and ileum ulcers (Fig. 2). The biopsies obtained from small intestinal ulcers showed diffuse intramucosal infiltration of medium-sized lymphoma cells and numerous atypical intraepithelial lymphocytes. Immunochemical staining revealed and CD3, CD8, and CD56 stains and negative result with the CD4. He was diagnosed with monomorphic epitheliotropic intestinal T-cell lymphoma and received chemotherapy. Monomorphic epitheliotropic intestinal T-cell lymphoma, or enteropathy-associated T-cell lymphoma type II, is an uncommon peripheral T-cell lymphoma often found in the small intestine. In this case, the duodenal mucosal changes and the hyperemic mucosa and multiple ulcers in the small bowel were in agreement with findings reported by several previous case reports. These findings may be characteristic of this disease entity.