Monomorphic epitheliotropic intestinal T-cell lymphoma presenting as melena with long-term survival: A case report and review of literature

Table 1 Laboratory data on admission

Items	Data	Reference	Items	Data	Reference	Items	Data	Reference
WBC	6720 /μL	3500-9100	TP	7.5 g/dL	6.4-8.4	γ-GTP	12 U/L	16-73
RBC	393 × 104 /μL	376-500	Alb	4.5 g/dL	3.6-5.2	Na	140 mEq/L	135-146
Hb	11.3 g/dL	11.3-15.2	BUN	26.0 mg/dL	6-22	Cl	107 mEq/L	96-108
Hct	34.2%	33.4-44.9	Cre	0.81 mg/dL	0.40-0.80	K	4.4 mEq/L	3.5-5.0
MCV	87.0 fL	79-100	T-bil	0.5 mg/dL	0.2-1.2	CRP	0.08 mg/dL	0-0.23
MCHC	33.0%	13.0-36.9	CK	140 U/L	43-165	sIL-2R	213 U/mL	145-519
Plt	21.4 × 104 /μL	13.0-16.9	AST	31 U/L	13-33	HBs Ag	(-)	(-)
PT	68%	70-130	ALT	12 U/L	6-30	HCV Ab	(-)	(-)
APTT	38.5 s	24-39	LDH	232 U/L	106-211	HTLV-1 Ab	(-)	(-)
			ALP	220 U/L	100-340

WBC: White blood cell; RBC: Red blood cell; Hb: Hemoglobin; Hct: Hematocrit; MCV: Mean corpuscular volume; MCHC: Mean corpuscular hemoglobin concentration; Plt: Platelets; PT: Prothrombin; APTT: Activated partial thromboplastin time; TP: Total protein; Alb: Albumin; BUN: Blood urea nitrogen; Cre: Creatinine; T-bil: Total bilirubin; CK: Creatine Kinase; AST: Aspartate transaminase; ALT: Alanine transferase; LDH: Lactate dehydrogenase; ALP: Alkaline phosphatase; γ-GTP: γ-glutamyl transpeptidase; Na: Sodium; Cl: Chloride; K: Potassium; CRP: C-reactive protein; sIL-2R: Soluble interleukin-2 receptor; HBs Ag: HBs antigen; HCV Ab: HCV antibody; HTLV-1 Ab: HTLV-1 antibody.

Table 2 Case reports of enteropathy-associated T-cell lymphoma and monomorphic epitheliotropic intestinal T-cell lymphoma presenting gastrointestinal bleeding

Case	Ref.	Age/Sex	Symptom	Location	Macroscopic finding	Perforation	Diagnosis	Treatment	Outcome
1	[13]	76/M	Gastrointestinal bleeding	Jejunum	Ulcer	Yes	EATL	Operation → chemotherapy	24 mo/alive
2	[14]	77/M	Positive for fecal occult bleeding	Jejunum	Ulcer, stenosis	No	MEITL	Operation	NA
3	[15]	68/M	Melena	Stomach	Ulcer (type 3 tumor)	No	MEITL	Chemotherapy	13 mo/death
4	[16]	65/M	Gastrointestinal bleeding	Stomach	NA	No	MEITL	Chemotherapy	13 mo/death
5	Our case	68/F	Melena	Duodenum	Ulcer	No	MEITL	Chemotherapy	66 mo/alive

NA: Not available; MEITL: Monomorphic epitheliotropic intestinal T-cell lymphoma; EATL: Enteropathy-associated T-cell lymphoma.