The Second People's Hospital of Shaanxi Province, Xi'an, Shaanxi Province, China.
Medicine (Baltimore). 2024 Jun 7;103(23):e38465. doi: 10.1097/MD.0000000000038465.
Intestinal T-cell lymphomas are exceedingly rare diseases. Intestinal T-cell lymphoma NOS, as a "wastebasket" category, is difficult to diagnosis. Endoscopy can identify abnormal mucosa in most patients at a reasonably early stage. Therefore, it is crucial to increase the understanding of endoscopists in terms of the endoscopic characteristics of ITCL.
A 74-year-old male alone with wasting as the major complaint, had multiple polypoid lesions in the large intestine. The patient then had endoscopic care.
Only 1 polypoid lesion on white-light endoscopy in the sigmoid colon was pathologically diagnosed as intestinal T-cell lymphomas, not otherwise specified (ITCL-NOS).
The patient underwent intensity-reduced CHOP therapy.
The patient is still with controlled disease but developed chemotherapy-related side effects.
In the individual with unexplained anemia and waste, endoscopy should not be delayed. For each of polypoid lesion on white-light endoscopy, the endoscopist need to remain cautious, because every lesion in the same patient can exhibit the independence of histopathological features. Meanwhile, we suggest that endoscopists should routinely observe the terminal ileum, even take biopsy samples if necessary.
肠 T 细胞淋巴瘤是极为罕见的疾病。肠 T 细胞淋巴瘤非特指型作为一个“分类垃圾桶”，诊断困难。内镜检查可使大多数患者在相当早的阶段发现异常黏膜。因此，提高内镜医生对 ITCL 内镜特征的认识至关重要。
一名 74 岁男性，因消瘦为主诉，大肠内有多个息肉样病变。患者随后进行了内镜检查。
乙状结肠白光内镜下仅发现 1 个息肉样病变，经病理诊断为肠 T 细胞淋巴瘤，非特指型（ITCL-NOS）。
患者接受了强度降低的 CHOP 治疗。
患者疾病仍处于控制中，但出现了化疗相关的副作用。
对于原因不明的贫血和消瘦患者，不应延迟进行内镜检查。对于白光内镜下的每个息肉样病变，内镜医生都需要保持警惕，因为同一患者的每个病变都可能表现出独立的组织病理学特征。同时，我们建议内镜医生应常规观察末端回肠，如果必要，还应进行活检取样。
