Objective: To clarify the clinical features of monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) with minor endoscopic abnormalities. Methods: The clinical data of 6 patients with MEITL characterized by minor endoscopic abnormalities in Peking Union Medical College Hospital from 2012 to 2016 were retrospectively analyzed, including clinical manifestations, endoscopic, pathological features, medications and prognosis. Results: Five out of 6 patients were male, with an average age of 61.2 years old. The median disease duration was 4.5 months. All patients initially presented with diarrhea without specific findings for serologic testing. CT enterography showed continuous intestinal lesions, including symmetric thickening of the bowel wall, abnormal hyperenhancement of mucosal surface and lymphadenopathy. Endoscopic appearances were only mildly abnormal, including mucosal swelling, atrophy of villus, mosaic sign and shallow ulcers. Histopathologic findings revealed massive small to medium sized T lymphocytes infiltration with positive expression of CD(3) and CD(8). Chemotherapy and palliative treatment were administrated after diagnosis. Conclusions: Clinical presentations of MEITL are non-specific with minor endoscopic abnormalities. Therefore, biopsy is indispensable for patients with a relatively normal endoscopic result.
目的：通过分析内镜下轻微病变的单形性嗜上皮性肠道T细胞淋巴瘤（MEITL）的临床特点，提高对其的认识及早期诊断水平。 方法：回顾性分析北京协和医院2012至2016年收治的6例内镜下轻微病变的MEITL患者的临床表现、小肠CT重建及内镜检查结果、病理特点及治疗随访情况。 结果： 6例MEITL患者中男5例，女1例，平均年龄61.2岁，中位病程4.5个月，多以腹泻为首发症状，多伴有低白蛋白血症、贫血，CT小肠成像可见肠道病变连续，对称性肠腔增厚、黏膜面异常强化及淋巴结肿大。内镜下病变轻微，可见黏膜肿胀、粗糙不平，小肠绒毛短缩及马赛克征、浅溃疡形成，病理见形态单一的小至中等大小T淋巴细胞浸润，表达CD(3)、CD(8)。 结论： MEITL的临床表现和辅助检查缺乏特异性，内镜下可仅有轻微病变。对疑诊MEITL的患者应积极在内镜下轻微病变处行病理组织活检以明确诊断。.
Keywords: Clinical features; Endoscopic manifestation; Lymphoma; Monomorphic epitheliotropic intestinal T-cell lymphoma.