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Hepatosplenic T-cell lymphoma in a patient with Crohn's disease

Nature Reviews Gastroenterology & Hepatology volume 6, pages 433–436 (2009)Cite this article

Abstract

Background. A 58-year-old man who had a 35-year history of Crohn's disease presented to our IBD center with a disease flare, pararectal fistulas and abscess formation. The patient had previously undergone ileocolic resection for a stenosis and his abscesses had been treated by surgical drainage. He had been taking azathioprine therapy for approximately 5.5 years and had received high-dose steroids. He had also previously taken metronidazole and antihypertensive medications.

Investigations. Physical examination, laboratory investigations including hemoglobin levels and white blood cell counts, genetic testing, CT, bone-marrow biopsy, immunophenotyping by fluorescence-activated cell sorting, polymerase chain reaction analyses, fluorescence in situ hybridization, sputum culture and diagnostic splenectomy.

Diagnosis. Hepatosplenic T-cell lymphoma.

Management. Splenectomy, antibiotic therapy and chemotherapy with cyclophosphamide.

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Figure 1: Histological image of the patient's spleen after splenectomy.
Figure 2: Immunohistochemical staining of a specimen from the patient's spleen revealed the presence of intrasinusoidal, CD3+ cells (asterisks).
Figure 3: Histological analysis of a specimen from the patient's spleen revealed the presence of proliferating cells.

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Authors and Affiliations

  1. Department of Medicine II, University Hospital, Munich-Grosshadern, Munich, Germany

    Florian Beigel, Matthias Jürgens, Cornelia Tillack, Burkhard Göke, Stephan Brand & Thomas Ochsenkühn

  2. Department of Medicine III, University Hospital, Munich-Grosshadern, Munich, Germany

    Marion Subklewe

  3. Department of Pathology, University Hospital, Munich-Grosshadern, Munich, Germany

    Doris Mayr

Authors
  1. Florian Beigel
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  2. Matthias Jürgens
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Correspondence to Florian Beigel.

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Beigel, F., Jürgens, M., Tillack, C. et al. Hepatosplenic T-cell lymphoma in a patient with Crohn's disease. Nat Rev Gastroenterol Hepatol 6, 433–436 (2009). https://doi.org/10.1038/nrgastro.2009.87

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