Jiang SJ, Ou CZ, Tang H, Li MH, Jia CW, Zhou WX, He ZYT, Li J, Zhang Y, Li JN. Monomorphic epitheliotropic intestinal T-cell lymphoma: Clinical, endoscopic and pathological features. World J Gastroenterol 2026; 32(16): 117259 [DOI: 10.3748/wjg.v32.i16.117259]
Corresponding Author of This Article
Ji Li, Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing 100730, China. liji0235@pumch.cn
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Gastroenterology & Hepatology
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Retrospective Study
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Apr 28, 2026 (publication date) through Apr 17, 2026
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World Journal of Gastroenterology
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1007-9327
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Jiang SJ, Ou CZ, Tang H, Li MH, Jia CW, Zhou WX, He ZYT, Li J, Zhang Y, Li JN. Monomorphic epitheliotropic intestinal T-cell lymphoma: Clinical, endoscopic and pathological features. World J Gastroenterol 2026; 32(16): 117259 [DOI: 10.3748/wjg.v32.i16.117259]
World J Gastroenterol. Apr 28, 2026; 32(16): 117259 Published online Apr 28, 2026. doi: 10.3748/wjg.v32.i16.117259
Monomorphic epitheliotropic intestinal T-cell lymphoma: Clinical, endoscopic and pathological features
Shi-Juan Jiang, Cheng-Zhu Ou, Hao Tang, Mu-Han Li, Cong-Wei Jia, Wei-Xun Zhou, Zhang-Yu-Ting He, Ji Li, Yan Zhang, Jing-Nan Li
Shi-Juan Jiang, Cheng-Zhu Ou, Hao Tang, Mu-Han Li, Ji Li, Jing-Nan Li, Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100730, China
Cong-Wei Jia, Wei-Xun Zhou, Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100730, China
Zhang-Yu-Ting He, Yan Zhang, Department of Hematology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100730, China
Co-first authors: Shi-Juan Jiang and Cheng-Zhu Ou.
Co-corresponding authors: Ji Li and Yan Zhang.
Author contributions: Jiang SJ and Ou CZ made equal contributions as co-first authors; Jiang SJ, Ou CZ, and Li MH retrieved and collected data from the Peking Union Medical College Hospital cohort and the literature cohort; Jiang SJ drafted the initial manuscript; Ou CZ was responsible for the statistical analysis of data and table construction; Tang H performed the retrieval, image interpretation, and analysis of endoscopic data; Jia CW and Zhou WX undertook the retrieval, review, and analysis of patients’ pathological data; He ZYT was in charge of patient screening; Zhang Y, Li J, and Li JN designed and guided the study, and provided resources and secured funding support; Li J supervised the review and revision of the manuscript; Zhang Y and Li J played equally crucial roles as co-corresponding authors. All authors approved the final version to publish.
Supported by Chinese Academy of Medical Sciences Innovations Fund for Medical Sciences, No. 2021-I2M-1-003; and Beijing Research Ward Excellence Program, No. BRWEP2024W034010110.
Institutional review board statement: The study was reviewed and approved by the Peking Union Medical College and Chinese Academy of Medical Science Institutional Review Board, No. I-23PJ406.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Corresponding author: Ji Li, Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing 100730, China. liji0235@pumch.cn
Received: December 3, 2025 Revised: December 23, 2025 Accepted: January 29, 2026 Published online: April 28, 2026 Processing time: 135 Days and 14.4 Hours
Abstract
BACKGROUND
Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is a rare, aggressive T-cell lymphoma involving the gastrointestinal tract, which was previously classified as enteropathy-associated T-cell lymphoma type II (EATL II).
AIM
To improve the understanding and diagnostic accuracy of MEITL, this study analyzed its clinical, endoscopic, and pathological characteristics.
METHODS
Patients who were diagnosed with MEITL or EATL II at Peking Union Medical College Hospital between August 2012 and June 2025 were retrospectively enrolled. Additionally, cases with confirmed diagnoses of EATL II or MEITL were retrieved from PubMed and Web of Science. Clinical symptoms, medical history, auxiliary examinations, endoscopic and pathological findings were collected for all included patients.
RESULTS
Among the 26 MEITL patients in Peking Union Medical College Hospital, the most common symptoms were weight loss (73%) and abdominal pain (65%), with 96% showing small intestinal involvement. Endoscopic findings in 10 patients showed mucosal edema (100%), roughness (100%), and villous blunting (90%). A review of 130 published MEITL cases revealed similar clinical profiles but heterogeneous endoscopic features. Ulceration (66%) was the most frequent in 64 cases with available data. Integrated analysis of 156 patients, stratified by a prediagnostic surgical history, showed nonsurgical group more frequently presented with diarrhea and weight loss (P < 0.001); surgical group had higher incidence of bowel perforation (P < 0.001) and higher expression of T-cell intracellular antigen 1 and granzyme B (P < 0.05), indicating aggressiveness.
CONCLUSION
Recognizing the characteristic symptoms and endoscopic features of MEITL is essential for improving the diagnostic accuracy and early identification of this rare and aggressive lymphoma.
Core Tip: This study analyzed 26 cases from Peking Union Medical College Hospital and 130 literature-reported cases of monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL). It found heterogeneous endoscopic manifestations. The Peking Union Medical College Hospital cohort mainly presented with subtle mucosal changes (edema, roughness, villous blunting), which may be early endoscopic signs of MEITL. Ulceration was the main endoscopic feature in the literature cohort, likely indicating disease progression. Multi-site deep biopsy combined with imaging is crucial for early accurate diagnosis of MEITL. Two clinical subtypes (acute aggressive and chronic consumptive) were identified, with distinct symptoms and pathological features, providing value for personalized clinical management.
