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Case Reports
. 2025 May 8;12(5):e01695.
doi: 10.14309/crj.0000000000001695. eCollection 2025 May.

A Rare Presentation of a Devastating Disease: Hepatosplenic T-Cell Lymphoma in Crohn's Disease Without Thiopurine Exposure

Michael Chang  1 , Michael Frohlinger  1 , Nathan Williams  2 , Lauren George  1
Affiliations
Case Reports

A Rare Presentation of a Devastating Disease: Hepatosplenic T-Cell Lymphoma in Crohn's Disease Without Thiopurine Exposure

Michael Chang et al. ACG Case Rep J. .

Abstract

Hepatosplenic T-cell lymphoma (HSTCL) is a rare, aggressive malignancy that has been associated with thiopurines during the treatment of inflammatory bowel disease (IBD). We present a case of a 26-year-old man with Crohn's disease on infliximab without prior thiopurine exposure who developed HSTCL. His diagnosis was confirmed through flow cytometry, fluorescence in situ hybridization, and bone marrow biopsy. This is the sixth case of HSTCL in patients with IBD without prior thiopurine exposure and highlights the need for a comprehensive risk-benefit discussion with patients on the various treatment modalities for IBD.

Keywords: Crohn's; hepatosplenic T-cell lymphoma; inflammatory bowel disease; thiopurines; tumor necrosis factor alpha inhibitors, infliximab.

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Figures

Figure 1.
Figure 1.
Flow cytometry on the pheripheral blood: (Lymphocytes highlighted in green). (A) T cells demonstrating negative cell surface makers for CD4 and CD8. (B) T cells reveal positive cell surface makers for T cell receptor (TCR) g/d and CD3.
Figure 2.
Figure 2.
PET/CT scan revealing increased FDG uptake in anterior and posterior spleen. CT, computed tomography; PET, positron emission tomography.
See this image and copyright information in PMC

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