Hepatosplenic T-cell lymphoma in a 47-year-old Crohn's disease patient on thiopurine monotherapy

Maartje M van de Meeberg; Lauranne A A P Derikx; Harm A M Sinnige; Peet Nooijen; D Lucette Schipper; Loes H C Nissen

doi:10.3748/wjg.v22.i47.10465

Hepatosplenic T-cell lymphoma in a 47-year-old Crohn's disease patient on thiopurine monotherapy

World J Gastroenterol. 2016 Dec 21;22(47):10465-10470. doi: 10.3748/wjg.v22.i47.10465.

Authors

Maartje M van de Meeberg¹, Lauranne A A P Derikx¹, Harm A M Sinnige¹, Peet Nooijen¹, D Lucette Schipper¹, Loes H C Nissen¹

Affiliation

¹ Maartje M van de Meeberg, Lauranne AAP Derikx, D Lucette Schipper, Loes HC Nissen, Department of Gastroenterology and Hepatology, Jeroen Bosch Hospital, 5200 ME 's-Hertogenbosch, The Netherlands.

Abstract

Hepatosplenic T-cell lymphoma (HSTCL) is a rare non-Hodgkin lymphoma with a high mortality rate. Higher incidence is reported in patients with inflammatory bowel disease, specifically in male patients that are younger than 35 years, and have been treated with thiopurine and tumor necrosis factor (TNF)-α inhibitor combination therapy for over 2 years. In this case report we describe a 47-year-old patient with Crohn's disease (CD) who developed HSTCL after having been treated with thiopurine monotherapy for 14 years. To our best knowledge, only eleven cases exist of patients with CD who developed HSTCL while on thiopurine monotherapy. We report the first patient with CD, older than 35 years, who developed HSTCL while on thiopurine monotherapy. This emphasizes that HSTCL risk is not limited to young men receiving both thiopurines and TNF-α inhibitors.

Keywords: Crohn’s disease; Hepatosplenic T-cell lymphoma; Immunosuppression; Thiopurine.

Publication types

Case Reports

MeSH terms

Antineoplastic Combined Chemotherapy Protocols / adverse effects
Azathioprine / administration & dosage
Azathioprine / adverse effects*
Biopsy
Crohn Disease / diagnosis
Crohn Disease / drug therapy*
Crohn Disease / immunology
Drug Administration Schedule
Fatal Outcome
Gastrointestinal Hemorrhage / chemically induced
Humans
Immunocompromised Host
Immunohistochemistry
Immunosuppressive Agents / administration & dosage
Immunosuppressive Agents / adverse effects*
Liver Neoplasms / chemically induced*
Liver Neoplasms / diagnosis
Liver Neoplasms / drug therapy
Liver Neoplasms / immunology
Lymphoma, T-Cell / chemically induced*
Lymphoma, T-Cell / diagnosis
Lymphoma, T-Cell / drug therapy
Lymphoma, T-Cell / immunology
Male
Middle Aged
Mucositis / chemically induced
Positron-Emission Tomography
Risk Factors
Splenic Neoplasms / chemically induced*
Splenic Neoplasms / diagnosis
Splenic Neoplasms / drug therapy
Splenic Neoplasms / immunology
Time Factors

Substances

Immunosuppressive Agents
Azathioprine