University of South Florida Morsani College of Medicine Tampa, FL
Rishi Bolla, MD1, Jinming Song, MD, PhD2, Natali Ronen, MD2, Saraswathi Cappelle, DO2, Aamir Dam, MD2, Schaffer Mok, MD2, Mark Friedman, MD2, Luis Pena, MD2, Anjuli K. Luthra, MD2 1University of South Florida Morsani College of Medicine, Tampa, FL; 2Moffitt Cancer Center, Tampa, FL Introduction: Angioimmunoblastic T-cell lymphoma (AITL) is a rare, non-Hodgkin lymphoma of helper T-cell origin. It is characterized primarily by lymphadenopathy but can also have extra-nodal involvement, most commonly affecting the skin (1). Gastrointestinal (GI) involvement is extremely rare, and only a few cases have been reported. Here we present a unique case of relapsed AITL involving the GI tract.
Case Description/
Methods: A 64-year-old female with history of AITL status post autologous stem cell transplant with relapsed disease was admitted for dyspnea, tachycardia, and diffuse abdominal pain with watery diarrhea. Contrasted tomography (CT) imaging demonstrated duodenal wall thickening, for which upper endoscopy was performed. An incidental superficial ulcer with stigmata of recent bleeding was found in the gastroesophageal junction (GEJ) [Figure 1]; the remainder of the endoscopic exam was normal. GEJ ulcer biopsies showed diffuse atypical lymphoid infiltrate with T-cell predominance suspicious for AITL (Figure 2). T-cell gene rearrangement testing confirmed the diagnosis. Discussion: GI involvement of AITL is particularly rare, with only 5 reported cases involving the stomach, colon, and rectum, but esophageal involvement has not been reported (2-6). Our patient’s presentation shows a unique feature of AITL not previously seen.
References
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Figure: Figure 1: A) Superficial ulcer in the lower esophagus at the gastroesophageal junction. B) Insufflated view of the ulcer.
Figure: Figure 2: A) H&E 10x: Diffuse atypical lymphoid infiltrate involving the squamous and glandular gastroesophageal junctional tissue. B) H&E 20x: The atypical lymphoid infiltrate is composed of mostly small mature and occasional larger atypical lymphocytes in the background of increased eosinophils. C) Immunohistochemical stain for CD3 shows T cell infiltrate, which are mostly CD4+ with subset loss of CD7. D) The atypical lymphoid infiltrate is strong positive for ICOS, a follicular helper T cell marker.
Disclosures: Rishi Bolla indicated no relevant financial relationships. Jinming Song indicated no relevant financial relationships. Natali Ronen indicated no relevant financial relationships. Saraswathi Cappelle: Olympus – Consultant. Aamir Dam indicated no relevant financial relationships. Schaffer Mok: Amgen – Consultant. Steris – Consultant. Mark Friedman indicated no relevant financial relationships. Luis Pena indicated no relevant financial relationships. Anjuli Luthra: Boston Scientific – Consultant. Cook Medical – Speakers Bureau.
Rishi Bolla, MD1, Jinming Song, MD, PhD2, Natali Ronen, MD2, Saraswathi Cappelle, DO2, Aamir Dam, MD2, Schaffer Mok, MD2, Mark Friedman, MD2, Luis Pena, MD2, Anjuli K. Luthra, MD2. P0723 - Extra-Nodal Esophageal Involvement of Relapsed Angioimmunoblastic T-Cell Lymphoma, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
