A Lethal Case of Monomorphic Epitheliotropic Intestinal T-Cell Lymphoma Presented as Asymptomatic Colonic Ulcer

Intestinal T-cell lymphoma is an uncommon type of non-Hodgkin lymphoma that primarily affects the gastrointestinal tract. Among the known subtypes, monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is a particularly aggressive form characterized by poor prognosis and high mortality. Its rarity and diverse clinical presentations hinder clinical research and the establishment of standardized treatment protocols. Additionally, the treatment response and overall survival rates are typically very low. Herein, we report the case of a 70-year-old man who was referred for evaluation of an asymptomatic colonic ulcer that could not be diagnosed by colonoscopic biopsy but was finally identified as MEITL following surgical resection. Although the patient was diagnosed relatively early during clinical evaluation, treatment initiation was delayed owing to intestinal perforation. Several clinical findings should be considered when diagnosing MEITL. First, early diagnosis is necessary for prompt treatment. Second, gastrointestinal lymphoma should be suspected in patients with atypical or unexplained gastrointestinal findings. When endoscopic biopsy is feasible, like in this case, careful sampling is essential. Lastly, even with early diagnosed, prompt therapeutic intervention is crucial, as MEITL can progress rapidly.