Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) complicated with intestinal obstruction and perforation.

We report the case of a patient who comes to the emergency department with abdominal pain, oral intolerance and bloody stools, being diagnosed with intestinal obstruction secondary to a jejunal tumor with contained perforation. A laparotomy was performed with resection of the jejunal tumor and taking biopsies from lesions with similar characteristics in the rest of the small bowel compatible with monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL). The monomorphic epitheliotropic intestinal T-cell lymphoma is a rare intestinal tumor with a poor prognosis that is characterized by the proliferation of intraepithelial lymphocytes. The abdominal symptoms are nonspecific and the known major complications are intestinal perforation and obstruction. There is no standard therapeutic approach, being a combination of surgical resection, chemotherapy and autologous stem cell transplant.

Colon adenocarcinoma associated with intestinal sarcoidosis.

Sarcoidosis is a multisystem chronic inflammatory disease of unknown etiology, characterized by non-caseating granulomas. Sarcoidosis has the potential to involve every tissue in the body, which mainly affect the lymphatic system and lungs; gastrointestinal system, and particularly the colon, is an extremely rare location. We report the case of a 64-year-old male with history of pulmonary and cutaneous sarcoidosis diagnosed with neoplasm in the hepatic flexure of the colon and a polyp with high-grade dysplasia in the transverse colon by colonoscopy after a positive fecal occult blood test. The case was presented to a multidisciplinary committee and it was decided to perform a total laparoscopic colectomy and ileorectal anastomosis with histopathological evidence of infiltrating adenocarcinoma and intestinal sarcoidosis with non-caseating granulomas in the appendix, terminal ileum, colon and locoregional lymph nodes. The relationship between colon cancer and sarcoidosis is controversial, with studies showing a possible increased risk of cancer in patients with sarcoidosis, relating it to the chronic proinflammatory state of the disease. In these cases, lymph node involvement is especially important when assessing tumor extension studies, and may lead to changes in staging and, as a consequence, in the therapeutic approach.