Primary T cell lymphoma of small intestine with perforation is a sinister combination: A case report of two cases

Abstract

Introduction-Primary T cell lymphoma of the gastrointestinal tract is a relatively rare heterogeneous group of lymphoid malignancies comprising various subtypes. Perforation is a serious life threatening complication of gastrointestinal tract lymphoma. Usually, perforation occurs after initiation of chemotherapy but rarely, it may be the initial presentation of the gastrointestinal tract lymphoma. T cell lymphoma of the small bowel presenting or getting complicated by perforation is of grave prognosis. Materials and Methods- We identified 2 cases of small intestine primary T cell lymphoma managed in a surgical unit of a tertiary care hospital. A retrospective review of data was done to elucidate clinical-pathological features and prognosis.  Results- Of the two patients identified, one was a 45 year old male presented with peritonitis secondary to perforation in the ileum. He underwent emergency laparotomy segmental enteral resection and anastomosis. The second patient was a 58 year old female patient admitted with complaint of recurrent abdominal pain. After surgical management and histopathological diagnosis, she was administered chemotherapy. She had perforation after the first cycle of chemotherapy. Both patients died 35 and 28 days respectively after first presentation to hospital. Conclusion-Our report highlights the fact that intestinal T cell lymphoma complicated by perforation either at the time of presentation or during the course of chemotherapy is of grim prognosis.