A Case of Enteropathy-Type Intestinal Natural Killer/T-cell Lymphoma Diagnosed by Autopsy

Seiji Umehara, Ai Hironaka, Akihiro Yamaguchi, Kiyoshi Uchiyama, Yoshihiro Shimizu and Tetsuhiro Minamikawa*

Department of Surgery and Department of Pathology*, Dai-ni Okamoto General Hospital

A 51-year-old man admitted for sudden anal bleeding, was found in colonoscopy to have a large ulcer in the descending colon, although biopsy disclosed only nonspecific inflammation. After a short remission, the man suddenly developed massive anal bleeding and hemorrhagic shock. Emergency laparotomy showed bleeding from a penetrating colon ulcer into the spleen and pancreas, necessitating partial colectomy including the penetration site, splenectomy, and distal pancreatectomy. Histopathology revealed massive necrosis of the entire colonic wall with resultant penetration, but prominent degenerative changes significantly limited further etiological evaluation of the lesion. Despite intensive treatment, the man died of fulminant hepatitis on day 77 after surgery. Autopsy showed enteropathic NK/T-cell lymphoma involving the intestines, kidneys, lungs, and liver. Although rare, enteropathic lymphoma should be considered as a differential diagnosis when an idiopathic colonic ulcer is found.

Key words
enteropathy-type T-cell lymphoma, primary colorectal malignant lymphoma, NK/T-cell lymphoma

Reprint requests
Seiji Umehara Department of Surgery, Dai-ni Okamoto General Hospital
54-14 Jinmyouisiduka, Uji, 611-0025 JAPAN

Accepted
October 22, 2008

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