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[Peripheral T cell lymphoma of the GI tract]

1. Origin of T cell and PTCL

- The T-cells are born from stem cells, similar to that of B-cells, but mature in the thymus.

- They help the immune system work in a coordinated fashion.

2016 WHO 분류

2. Gastrointestinal T cell lymphoma

- Owing to the rarity the ideal treatment remains controversial.

- Primary surgery followed by CCT is best.

- A higher frequency of intestinal perforation and bleeding noted by some if Sx is omitted.

- In the largest series by Daum et al (n = 35, J Clin Oncol 21:2740-2746), 2yr OS was 28% only

- In another large series by Gale et al (n = 31, J Clin Oncol 2000;18:795), 5-year OS was 19.7%,and 5-year failure-free survival rate was only 3.2%.

PTCL: chronic diarrhea, loss of weight (15 kg), and night sweat

Colon T cell lymphoma

Colon T cell lymphoma

T cell lymphoma of the terminal ileum

만성복통. 수개월 검사 후 jejunal obstruction으로 수술하여 진단한 PTCL

3. PTCL of the stomach

- Rare (7% of the stomach lymphomas, from Japan)

- Thought to be of viral origin

- Human T-cell leukemia virus (HTLV-1) and Epstein-Barr virus (EBV)

- Any role for HP in the development of gastric T-cell lymphomas is not known

- Sometimes, it may be difficult to diagnose gastric T-cell lymphomas based on superficial biopsies of the stomach

- The depth of the biopsy will determine the diagnostic accuracy of the procedure Gastric T-cell lymphomas reportedly have worse prognoses than their B-cell counterparts

4. Endoscopic findings of PTCL of the stomach

5. Screening endoscopy에서 발견된 gastric PTCL

5. Indolent type GI T cell lymphoma

© 일원내시경교실 바른내시경연구소 이준행. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng.