Asunto(s)
Neoplasias Duodenales/diagnóstico , Linfoma Folicular/diagnóstico , Neoplasias Duodenales/metabolismo , Neoplasias Duodenales/patología , Duodenoscopía , Femenino , Humanos , Inmunohistoquímica , Linfoma Folicular/metabolismo , Linfoma Folicular/patología , Persona de Mediana Edad , Proteínas Proto-Oncogénicas c-bcl-2/metabolismoAsunto(s)
Endosonografía/métodos , Mucosa Gástrica/patología , Gastroscopía/métodos , Neoplasias Gástricas/diagnóstico , Colorantes , Mucosa Gástrica/cirugía , Humanos , Carmin de Índigo , Estadificación de Neoplasias , Neoplasias Gástricas/diagnóstico por imagen , Neoplasias Gástricas/patología , Neoplasias Gástricas/cirugíaRESUMEN
We describe a case of adult T-cell leukemia (ATL) with intestinal infiltration. In the early clinical stage, the endoscopic findings for the intestine were similar to those of amebic enterocolitis, i.e., varioliform mucosal polypoid lesions, and amebic cyst was detected with stool examination. Although no specific pathological factor could be identified on biopsy, the patient was treated for amebiasis as a diagnostic therapy. The findings of varioliform mucosal polypoid lesions were detected in the duodenum on endoscopic examination, but the lesions eventually disappeared during the treatment for amebiasis. We then suspected lymphoma partially masked by the amebiasis. Immunological staining of a specimen of the colonic mucosa revealed T cell invasion and Southern blotting demonstrated adult T-cell leukemia provirus invasion. Thus, ATL cell infiltration of the intestinal tract was confirmed. It is suggested that systemic disease should also be considered when varioliform mucosal polypoid lesions are found on colonoscopic examination.