Chen X, Bo JQ, Gao XX, Zhang SX, Li J, Wang H, Yang MY, Guo QQ, Xiu B, Zeng Y. Indolent T-cell lymphoma of the gastrointestinal tract coexisting with gastric signet-ring cell carcinoma: A case report and review of literature. World J Gastroenterol 2025; 31(47): 112705 [DOI: 10.3748/wjg.v31.i47.112705]
Corresponding Author of This Article
Yu Zeng, MD, PhD, Chief Physician, Department of Pathology, Tongji Hospital Affiliated to Tongji University School of Medicine, No. 389 Xincun Road, Putuo District, Shanghai 200065, China. yuzeng2013@163.com
Research Domain of This Article
Pathology
Article-Type of This Article
Case Report
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 21, 2025 (publication date) through Dec 19, 2025
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Journal Information of This Article
Publication Name
World Journal of Gastroenterology
ISSN
1007-9327
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Chen X, Bo JQ, Gao XX, Zhang SX, Li J, Wang H, Yang MY, Guo QQ, Xiu B, Zeng Y. Indolent T-cell lymphoma of the gastrointestinal tract coexisting with gastric signet-ring cell carcinoma: A case report and review of literature. World J Gastroenterol 2025; 31(47): 112705 [DOI: 10.3748/wjg.v31.i47.112705]
Xue Chen, Jia-Qi Bo, Su-Xia Zhang, Jie Li, Hui Wang, Mu-Ye Yang, Qian-Qian Guo, Yu Zeng, Department of Pathology, Tongji Hospital Affiliated to Tongji University School of Medicine, Shanghai 200065, China
Xiao-Xiang Gao, Department of Orthopedics, Chinese People's Liberation Army Naval Medical Center, Shanghai 200052, China
Bing Xiu, Department of Hematology, Tongji Hospital Affiliated to Tongji University School of Medicine, Shanghai 200065, China
Co-first authors: Xue Chen and Jia-Qi Bo.
Co-corresponding authors: Bing Xiu and Yu Zeng.
Author contributions: Chen X and Bo JQ were primarily involved in literature retrieval, consultation, paper writing, in charge of T-cell receptor rearrangement detection and result interpretation as the co-first authors of the paper; Gao XX looked through books and other sources for information; Zhang SX interpreted the data of the immunohistochemical results; LI J, Wang H, Yang MY and Guo QQ consulted the literature, providing retrieval, corresponding clinical data and follow-up information; Xiu B and Zeng Y revised it critically for important intellectual content as the co-corresponding authors; Zeng Y gave financial assistance for this study; all authors have read and approved the final manuscript.
Supported by Key Disciplines of The Sixth Cycle of Tongji Hospital, No. ZDTS24-BL; Shanghai Municipal Science and Technology Commission 2021 "Science and Technology Innovation Action Plan" Medical Innovation Research Project, No. 21Y11908800; and Clinical Research Project of Tongji Hospital of Tongji University, No. ITJ(ZD) 2206.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu Zeng, MD, PhD, Chief Physician, Department of Pathology, Tongji Hospital Affiliated to Tongji University School of Medicine, No. 389 Xincun Road, Putuo District, Shanghai 200065, China. yuzeng2013@163.com
Received: August 19, 2025 Revised: September 28, 2025 Accepted: November 4, 2025 Published online: December 21, 2025 Processing time: 123 Days and 2.5 Hours
Abstract
BACKGROUND
Indolent T-cell lymphoma of the gastrointestinal tract (iTCL-GI) is a rare mature T-cell lymphoma that has been formally recognized as a distinct entity in the 5th Edition World Health Organization Classification of Tumours of Haematolymphoid Tumours. However, the coexistence of iTCL-GI with epithelial malignancies is rare in clinical practice. This study reports a case of iTCL-GI with gastric signet-ring cell carcinoma (SRCC). We aim to increase diagnostic awareness among clinicians and pathologists regarding multiple primary tumors.
CASE SUMMARY
A 65-year-old female presented with a 5-month history of lower abdominal pain, bloating, and vomiting. An abdominal computed tomography scan revealed irregular thickening of the gastric wall. Endoscopy revealed diffuse mucosal edema and rigid mucosa along the lesser curvature of the gastric body. There was a 1.5 cm mucosal protrusion on the greater curvature. Biopsy revealed that the lamina propria was expanded by a dense, nondestructive infiltrate of small lymphocytes in the greater curvature, which were characterized by a CD3+/CD8+/TIA-1+ immunophenotype with a low Ki-67 index. Clonal T-cell receptor rearrangement was detected, but the Epstein-Barr virus encoded RNA's was negative. Lesions on the lesser curvature of the gastric body were confirmed to be SRCCs. After three months of follow-up, the patient completed four cycles of chemotherapy targeting the SRCC. While her abdominal pain improved, she experienced a weight loss of 5 kg.
CONCLUSION
Clinicians and pathologists must integrate assessment of these rare cases to prevent misdiagnosis and guide clinical practice.
Core Tip: This article is the first to present a rare case of indolent T-cell lymphoma of the gastrointestinal tract coexisting with gastric signet-ring cell carcinoma. The immunohistochemistry results revealed that CD3, CD8, and TIA-1 expression was positive, whereas the Ki-67 score was low. Clonal T-cell receptor rearrangement was detected. The main differential diagnoses were aggressive T-cell lymphomas and inflammatory issues. This rare case emphasizes that clinicians and pathologists need greater awareness of multiple primary malignant tumors.
