Monomorphic Epitheliotropic Intestinal T-cell Lymphoma With Initial Pulmonary Symptoms: A Case Report.

Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is a rare and aggressive T-cell lymphoma that primarily affects the small intestine. Our case highlights a 60-year-old woman who initially presented with dyspnea, cough, and hemoptysis, followed by gastrointestinal symptoms during hospitalization. Imaging revealed cavitary lung masses, and biopsies confirmed MEITL with a TCR-delta+, CD8+, CD56+, and CD103+ immunophenotype. Endoscopy revealed duodenal nodularity and gastric ulcers; colonoscopy showed diffuse colonic inflammation. This case emphasizes the rare pulmonary involvement in MEITL and expands the limited literature on its extraintestinal manifestations. Clinicians should maintain a high index of suspicion for MEITL in patients presenting with both pulmonary and concurrent gastrointestinal complaints. Early recognition and biopsy-driven diagnosis are critical for timely intervention in this aggressive malignancy.