Indolent T-cell lymphoproliferative disease with synchronous diffuse large B-cell lymphoma: A case report

• Published in: Medicine (Baltimore) Vol. 98; no. 17; p. e15323
• Main Authors: Guo, Linjie, Wen, Zhonghui, Su, Xueying, Xiao, Shuyuan, Wang, Yufang
• Format: Journal Article
• Language: English
• Published: United States the Author(s). Published by Wolters Kluwer Health, Inc 01-04-2019; Wolters Kluwer Health
• Subjects: Antineoplastic Agents - therapeutic use; Clinical Case Report; Humans; Intestinal Perforation - complications; Intestinal Perforation - surgery; Lymphoma, Large B-Cell, Diffuse - complications; Lymphoma, Large B-Cell, Diffuse - drug therapy; Lymphoproliferative Disorders - complications; Male; Middle Aged; T-Lymphocytes
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000015323

Indolent T-cell lymphoproliferative disease (T-LPD) of gastrointestinal tract is a rare recently described disease that seldom progresses. We report a case of T-LPD with synchronous diffuse large B-cell lymphoma (DLBCL) that cause aggravation of disease.
A 46-year-old Chinese male presented with intermittent paraumbilical colic pain, bloating, and occasional diarrhea for 10 years. His condition aggravated with partial bowel obstruction recently. The patient was diagnosed as T-LPD initially based on histological result and T-cell receptor-gamma clonal gene rearrangement test. The patient was followed without chemotherapy. His condition stabilized for 1 year and then deteriorated with small intestine perforation.
The patient was diagnosed as indolent T-LPD and DLBCL finally.
The patient had surgery for intestine perforation and received chemotherapy for DLBCL and T-LPD afterward.
At 6 months follow-up, the patient continued to have resolution of his symptoms.
Early detection of high-grade transformation of T-LPD or the coexistence of aggressive lymphoma is essential for the patient. DLBCL may coexist in the indolent course of T-LPD. The diagnosis of T-LPD should be made cautiously in case with progressing symptoms such as intestinal obstruction.