Okuda Takehiro, Shirase Tomoyuki, Nishikubo Masashi, Konishi Yuki, Takeoka Tomoharu, Takeshima Jun, Ito Tatsuo, Tsuji Masaaki
Department of Hematology, Otsu Red Cross Hospital, Otsu, Shiga 520-8511, Japan.
Department of Pathology, Otsu Red Cross Hospital, Otsu, Shiga 520-8511, Japan.
Mol Clin Oncol. 2025 May 22;23(1):67. doi: 10.3892/mco.2025.2862. eCollection 2025 Jul.
Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is a rare and aggressive primary intestinal lymphoma with a poor prognosis. MEITL can metastasize to the central nervous system, liver and spleen, but gallbladder involvement has not yet been reported. The present study describes the case of a 57-year-old woman who presented with abdominal distention, pain and vomiting. Contrast-enhanced computed tomography revealed thickening and perforation of the small intestinal wall, and a gallbladder mass. Histopathological analysis of the affected small intestine and gallbladder revealed a dense infiltrate of medium-sized monomorphic lymphocytes with a CD3, CD4, CD8 and TIA-1 phenotype. Based on the absence of celiac disease, aggressive clinical course, and characteristic histopathological and immunophenotypic features, a diagnosis of MEITL with gallbladder involvement was established. The patient underwent small intestinal resection and cholecystectomy, followed by chemotherapy, which was completed without gastrointestinal or gallbladder perforation. Diagnostic resection is currently the best approach for suspected malignant lymphoma of the gallbladder. This rare case of MEITL with gallbladder involvement highlights the importance of considering this diagnosis in similar clinical scenarios and the role of cholecystectomy, which can serve both diagnostic and therapeutic purposes.
单形性上皮趋化性肠道T细胞淋巴瘤（MEITL）是一种罕见且侵袭性强的原发性肠道淋巴瘤，预后较差。MEITL可转移至中枢神经系统、肝脏和脾脏，但胆囊受累尚未见报道。本研究描述了一名57岁女性患者，她出现腹胀、腹痛和呕吐症状。增强计算机断层扫描显示小肠壁增厚和穿孔，以及胆囊肿块。对受累小肠和胆囊进行组织病理学分析，发现有密集浸润的中等大小单形性淋巴细胞，具有CD3、CD4、CD8和TIA-1表型。基于无乳糜泻、侵袭性临床病程以及特征性的组织病理学和免疫表型特征，确诊为累及胆囊的MEITL。患者接受了小肠切除术和胆囊切除术，随后进行化疗，化疗过程中未出现胃肠道或胆囊穿孔。目前，诊断性切除术是疑似胆囊恶性淋巴瘤的最佳治疗方法。这例罕见的累及胆囊的MEITL病例凸显了在类似临床情况下考虑该诊断的重要性，以及胆囊切除术兼具诊断和治疗作用的价值。
