Monomorphic epitheliotropic intestinal T-cell lymphomas: a case report

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.

Pegylated liposomal doxorubicin (PLD)-containing regimen as a novel treatment of monomorphic epithelial intestinal T-cell lymphoma (MEITL): A case report and review of literature

INTRODUCTION

Monomorphic intestinal T-cell lymphoma (MEITL) is a rare, aggressive peripheral T-cell lymphoma that arises from intestinal epithelial lymphocytes. Currently, MEITL lacks standard treatment options. Under the current treatment regimen, the median survival time for patients is only 7 months. Chemotherapy followed by hematopoietic stem cell transplantation may improve patient outcomes. New anti-lymphoma drugs, including chidamide and PEG-asparaginase, are being tested against MEITL. To our knowledge, there are currently no data on the pegylated liposomal doxorubicin (PLD) regimen for MEITL therapy.Patient concerns, diagnosis and interventions: We report the case of a 54-year-old patient diagnosed with MEITL who presented with abdominal pain and was treated with a cyclophosphamide, doxorubicin, vincristine, prednisone, etoposide regimen containing PLD.

OUTCOMES

After 15 months of follow-up, the patient is currently alive and disease free. The application of doxorubicin liposomes in chemotherapy regimens may be a new way to treat MEITL.

REVIEW

We searched the literature on MEITL and selected 52 case reports. We summarized the clinical characteristics and treatment of 53 patients (including the current patient).

CONCLUSION

It highlights 2 important clinical findings. First, for patients with MEITL treated with the cyclophosphamide, doxorubicin, vincristine, prednisone, etoposide regimen, PLD has fewer adverse reactions and better long-term survival than doxorubicin. Second, an early diagnosis is necessary for prompt treatment. We believe that this manuscript will be valuable to all the researchers who are interested in.