Abstract
BackgroundColorectal T/natural killer (NK)-cell lymphomas (TNKCL) are very rare. Endoscopic and clinicopathological characteristics of colorectal TNKCL have not been clearly demonstrated. In this study, we demonstrated the clinical characteristics of colorectal TNKCL.MethodsEndoscopic and clinicopathological characteristics were investigated in 27 patients with colorectal monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL), adult T-cell leukemia/lymphoma (ATLL), and other types of TNKCL.ResultsNine TNKCL patients (33%) were classified as MEITL, 11 (41%) as ATLL, and seven (26%) as other. Four patients with Epstein-Barr Virus-positive (EBV+) TNKCL, two indolent T-cell lymphoproliferative disorder and one anaplastic large cell lymphoma were included in the other group. Endoscopically, six MEITL (67%) and five ATLL (46%) showed diffuse-infiltrating type, in which the main endoscopic lesion was edematous mucosa in MEITL, while aphthoid erosion and edematous mucosa were typical in ATLL. Ulcerative type was identified in four other group patients (57%), including two EBV+ TNKCL. An increase in atypical T-intraepithelial lymphocytes (T-IELs) was noted in seven MEITL (88%) and six ATLL (60%) patients, but not in the other group (0%) patients. Five MEITL patients (56%) showed features of lymphocytic proctocolitis with increased CD8+ T-IELs.ConclusionsMEITL and ATLL occasionally invaded the colorectum, and primary involving MEITL was observed. Diffuse infiltrating type was the characteristic endoscopic finding in colorectal MEITL and ATLL, while ulcerative type was observed in the other group. Features of lymphocytic proctocolitis may be prodromal findings of MEITL.
Highlights
Colorectal T/natural killer (NK)-cell lymphomas (TNKCL) are very rare
One patient with Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) and one with Epstein-barr virus (EBV)+ CD56+ TNKCL each had a long history of ulcerative colitis (UC) treated with mesalazine, of 13 and 17 years, respectively
Six patients were considered as primary colorectal TNKCL without other GI tumor involvement
Summary
Colorectal T/natural killer (NK)-cell lymphomas (TNKCL) are very rare. Endoscopic and clinicopathological characteristics of colorectal TNKCL have not been clearly demonstrated. Intestinal Epstein-Barr viruspositive (EBV+) TNKCL is mainly reported in East Asia and consists of CD56+/negative and CD8+/negative lymphoid cells [8, 9]. EATL, MEITL, EBV+ TNKCL and indolent TLPD mainly involve the small intestine, and colorectal tumor invasion has occasionally been reported [6,7,8,9,10,11,12]. Primary colorectal B-cell lymphoma is found mainly in the ileocecum and endoscopically shows predominantly ulcerative and polypoid types, while diffuse infiltrating type is rare [15]. Small and large intestinal TNKCL including colorectal MEITL and EBV+ TNKCL often presents ulcero-infiltrative, ulcerating, and ulcerofungating type lesions [16]. The endoscopic and clinicopathological characteristics of colorectal TNKCL have rarely been reported worldwide [16, 17]
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