Monomorphic Epitheliotropic Intestinal T-cell Lymphoma of the Stomach: Two Case Reports and a Literature Review

Int J Surg Pathol. 2021 Jun;29(4):410-419. doi: 10.1177/1066896920953906. Epub 2020 Aug 28.

Abstract

We describe the clinicopathologic and molecular features of 2 cases of gastric monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL), which were first diagnosed from gastric biopsies, one was primary whereas the other was gastric involvement by MEITL. Both cases were older men with stomach ulcers. Case 1 was admitted for a hemorrhage in the upper digestive tract and case 2 for edema. Histology of both cases showed infiltrated monomorphic and medium-sized lymphocytes with lymphoid epithelial phenomenon. An inflammatory background and vascular hyperplasia were also observed likely due to the ulceration. Neoplastic cells expressed CD2, CD3, CD7, CD8, CD56, TIA-1, and MYC, not CD5, CD4, Granzyme B, CD20, CD30, TdT, or EBER. Both lymphomas showed TCRG gene rearrangement and c-MYC gains. Moreover, we first affirmed polysomy of chromosome 8 in case 2. For correct diagnosis of this rare tumor at the rare location, it is important that pathologists raise the possibility and exclude other differential diagnoses.

Keywords: EBER; MEITL; T-cell receptor; c-MYC; monomorphic epitheliotropic intestinal T-cell lymphoma; stomach.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Biomarkers, Tumor / analysis
  • Biomarkers, Tumor / genetics
  • Diagnosis, Differential
  • Endoscopy, Digestive System
  • Gastric Mucosa / diagnostic imaging
  • Gastric Mucosa / pathology*
  • Gene Rearrangement
  • Humans
  • Lymphoma, T-Cell / diagnosis*
  • Lymphoma, T-Cell / genetics
  • Lymphoma, T-Cell / pathology
  • Male
  • Positron Emission Tomography Computed Tomography
  • Stomach Neoplasms / diagnosis*
  • Stomach Neoplasms / genetics
  • Stomach Neoplasms / pathology

Substances

  • Biomarkers, Tumor