ArticleBMC gastroenterology2026
Small bowel lymphoma presenting with frequent perforation: a single center experience focusing on the monomorphic epitheliotropic intestinal T-cell lymphoma.
Article in BMC gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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5 authors.
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Abstract
backgroundSmall bowel malignancies are rare and initial symptoms are generally vague and non-specific. Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is a primary lymphoma of the gastrointestinal tract typically localizing to the small bowel. We attempted to analyze small bowel lymphoma patients in a tertiary care center focusing on the current diagnostic and treatment strategies of MEITL.
methodsWe reviewed patients with histopathology diagnosis of small bowel lymphoma from January 1998 to December 2018. Survival analysis was performed using the Kaplan–Meier method.
resultsThere were 140 lymphoma patients with small bowel involvement including 13 MEITL patients (9%). The incidence of small bowel perforation was much higher in MEITL patients than the non-MEITL small bowel lymphoma patients (46% versus 8%, p < .001). MEITL was significantly associated with weight loss, chronic diarrhea, elevated white blood cell counts, and low albumin levels. Most MEITL patients had jejunal involvement with diffuse bowel wall thickening and luminal narrowing in imaging studies. Enteroscopic findings in MEITL were typically characterized by edematous mucosal thickening and multifocal shallow ulcerations, frequently observed alongside a mosaic mucosal pattern or diffuse erosions. Most MEITL patients had received chemotherapy, and two patients received chemotherapy along with autologous stem cell transplantation. The median survival of MEITL was 8.0 months, and was significantly associated with age, performance, perforation status, and anthracycline chemotherapy.
conclusionsAs a rare lymphoma with poor prognosis, MEITL should be considered in Asian patients with jejunal lesions presenting with weight loss, chronic diarrhea, bowel perforation, and characteristic imaging/endoscopic features. Intensive chemotherapy followed by autologous stem cell transplantation may provide a better outcome.
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