Enteropathy Associated T Cell Lymphoma (EATL)

  • – It is a complication of celiac disease
  • – Malignant transformation of intraepithelial T cell
  • – Most patients die within few months
  • – Treatment of celiac disease with GFD may decrease the risk of this malignancy
  • – Tumor typically occur in the jejunum but other site of small intestine may be involved
  • – Median age of diagnosis: 60 years
  • – Gross findings:
  •               • Ulcerating lesion
  •               • Circumferential involvement of small intestine
  •               • Lesion may be
  •               • Nodule
  •               • Plaque
  •               • Stricture
  •               • Large masses (uncommon)
  • – Mesenteric lymph node may be enlarged due to tumor involvement and or reactive changes
  • – Distant sites with specifically the bone marrow or liver are sometimes involved
  • – The uninvolved mucosa usually has the typical appearance of celiac disease
  •                           • Villous atrophy
  •                           • Crypt hyperplasia
  •                           • Plasmacytosis in lamina propria
  •                           • Inceased intraepithelial lymphocyte

 

  • Symptoms of EATL
  • – H/o documented celiac disease
  • – Abdominal pain
  • – Weight loss
  • – Diarrhoea, vomiting
  • – Fever, night sweat, small bowel obstruction, perforation (less common)
  • – Rarely abdominal mass
  • Extraintestinal involvement
  •                   • Liver
  •                  • Spleen
  •                  • Thyroid
  •                  • Skin
  •                  • Brain
  • Treatment:
  • – Surgery followed by chemotherapy

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