Year 2024 / Volume 116 / Number 3
Letter
Hepatosplenic T-cell lymphoma and inflammatory bowel disease

175-176

DOI: 10.17235/reed.2023.9472/2023

Laura Gutiérrez-Rios, Eva Vayreda, Margalida Calafat, Míriam Mañosa, Eugeni Domènech, Fiorella Cañete,

Abstract
A 48-year-old man with a diagnosis of ulcerative colitis 18 years ago, under immunosuppressive treatment with azathioprine in the last 6 years due to corticosteroid dependence, was admitted to the Emergency Department due to fever of one week’s evolution. Blood tests showed thrombocytopenia, CRP 96.9mg/L, ferritin 3021ng/mL and hypertriglyceridemia. Blood and urine cultures were negative. Viral serologies (hepatitis B and C, HIV, parvovirus, CMV, HSV), atypical bacteria (Borrelia, Chlamydia, Coxiella) and screening for latent tuberculosis were also negative. Thoracoabdominal CT scan only showed splenomegaly. The bone marrow aspirate revealed immature lymphoid cells and a hemophagocyte figure, fulfilling the criteria for hemophagocytic syndrome, starting corticosteroid therapy at a dose of 1mg/Kg. Subsequently, the existence of an intrasinusoidal CD3 + CD5- lymphoid infiltrate and a FISH study with isochromosome 7q was reported, a characteristic pattern of hepatosplenic T-cell lymphoma (HSTCL). The study was completed with liver biopsy appreciating a 70% infiltration of T lymphocytes (50% gamma-delta) therefore the diagnosis was confirmed. Chemotherapy (cyclophosphamide, doxorubicin, vincristine, etoposide) was started with the aim of considering hematopoietic stem cell transplantation. Unfortunately, the patient died 6 months later.
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References
1. Yabe M, Miranda RN, Medeiros LJ. Hepatosplenic T-cell lymphoma: a review of clinicopathologic features, pathogenesis, and prognosis factors. Hum Pathol. 2018;74:5-16.
2. Kotlyar DS, Osterman MT, Diamond RH et al. A systematic review of factors that contribute to hepatosplenic T-cell lymphoma in patients with inflammatory bowel disease. Clinical Gastroenterology and Hepatology 2011; 9:36-41.
3. Annese V, Beaugerie L, Egan L, et al. ECCO. European Evidence-based Consensus: Inflammatory Bowel Disease and Malignancies. J Crohns Colitis. 2015; 9:945-65.
4. Shan ED, Coburn ES, Nayyar A, Jo Lee K, et al. Systematic review: hepatosplenic T-cell lymphoma on biologic therapy for inflammatory bowel disease, including data from the Food and Drug Administration Adverse Event Reporting System. Aliment Pharmacol Ther. 2020;00-1-7. DOI: 10.1111/apt.15637.
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Citation tools
Gutiérrez-Rios L, Vayreda E, Calafat M, Mañosa M, Domènech E, Cañete F, et all. Hepatosplenic T-cell lymphoma and inflammatory bowel disease . 9472/2023


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Publication history

Received: 13/01/2023

Accepted: 18/04/2023

Online First: 12/05/2023

Published: 04/03/2024

Article Online First time: 119 days

Article editing time: 416 days


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