S4226 Extra-Nodal Esophageal Involvement of Relapsed Angioimmunoblastic T-Cell Lymphoma

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. 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 woman 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 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); the remainder of the endoscopic exam was normal. GEJ ulcer biopsies showed diffuse atypical lymphoid infiltrate with T-cell predominance suspicious for AITL. 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.