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Case Reports
. 2016 Dec 21;22(47):10465-10470.
doi: 10.3748/wjg.v22.i47.10465.

Hepatosplenic T-cell lymphoma in a 47-year-old Crohn's disease patient on thiopurine monotherapy

Maartje M van de Meeberg  1 , Lauranne A A P Derikx  1 , Harm A M Sinnige  1 , Peet Nooijen  1 , D Lucette Schipper  1 , Loes H C Nissen  1
Affiliations
Case Reports

Hepatosplenic T-cell lymphoma in a 47-year-old Crohn's disease patient on thiopurine monotherapy

Maartje M van de Meeberg et al. World J Gastroenterol. .

Abstract

Hepatosplenic T-cell lymphoma (HSTCL) is a rare non-Hodgkin lymphoma with a high mortality rate. Higher incidence is reported in patients with inflammatory bowel disease, specifically in male patients that are younger than 35 years, and have been treated with thiopurine and tumor necrosis factor (TNF)-α inhibitor combination therapy for over 2 years. In this case report we describe a 47-year-old patient with Crohn's disease (CD) who developed HSTCL after having been treated with thiopurine monotherapy for 14 years. To our best knowledge, only eleven cases exist of patients with CD who developed HSTCL while on thiopurine monotherapy. We report the first patient with CD, older than 35 years, who developed HSTCL while on thiopurine monotherapy. This emphasizes that HSTCL risk is not limited to young men receiving both thiopurines and TNF-α inhibitors.

Keywords: Crohn’s disease; Hepatosplenic T-cell lymphoma; Immunosuppression; Thiopurine.

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Conflict of interest statement

Conflict-of-interest statement: All the authors have no conflicts of interests to declare.

Figures

Figure 1
Figure 1
Positron emission tomography showing hepatosplenomegaly with increased metabolic activity in liver, spleen and bone marrow. Left: Coronal plane; Right: Sagittal plane.
Figure 2
Figure 2
Liver biopsy showing hepatosplenic T-cell lymphoma. Left: Hematoxylin and eosin staining (magnification × 100) showing intrasinusoidal and portal infiltration of atypical lymphocytes; Right: CD3 staining (magnification × 100) showing neoplastic cells (appearing in brown colour).
See this image and copyright information in PMC

References

    1. Ferreri AJ, Govi S, Pileri SA. Hepatosplenic gamma-delta T-cell lymphoma. Crit Rev Oncol Hematol. 2012;83:283–292. - PubMed
    1. Rosh JR, Gross T, Mamula P, Griffiths A, Hyams J. Hepatosplenic T-cell lymphoma in adolescents and young adults with Crohn’s disease: a cautionary tale? Inflamm Bowel Dis. 2007;13:1024–1030. - PubMed
    1. Thai A, Prindiville T. Hepatosplenic T-cell lymphoma and inflammatory bowel disease. J Crohns Colitis. 2010;4:511–522. - PubMed
    1. Kotlyar DS, Osterman MT, Diamond RH, Porter D, Blonski WC, Wasik M, Sampat S, Mendizabal M, Lin MV, Lichtenstein GR. A systematic review of factors that contribute to hepatosplenic T-cell lymphoma in patients with inflammatory bowel disease. Clin Gastroenterol Hepatol. 2011;9:36–41.e1. - PubMed
    1. Kotlyar DS, Blonski W, Diamond RH, Wasik M, Lichtenstein GR. Hepatosplenic T-cell lymphoma in inflammatory bowel disease: a possible thiopurine-induced chromosomal abnormality. Am J Gastroenterol. 2010;105:2299–2301. - PubMed

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