Successful Diagnosis of Type II Enteropathy-associated T-cell Lymphoma Using Flow Cytometry and the Cell Block Technique of Celomic Fluid Manifesting as Massive Pyoid Ascites that Could Not Be Diagnosed via Emergency Laparotomy

• Published in: Internal Medicine Vol. 53; no. 2; pp. 129 - 133
• Main Authors: Hashimoto, Shinichiro, Nakamura, Shunta, Tanaka, Hiroaki, Ambiru, Satoshi, Itabashi, Terumi, Shimura, Takenori, Takeda, Yusuke, Kawajiri, Chika, Nakaseko, Chiaki, Furuya, Seiji, Nagao, Yuhei
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.01.2014
• Subjects: Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; ascites; Ascites - diagnosis; Ascites - pathology; Carcinoma, Renal Cell - surgery; cell block technique; Cyclophosphamide - administration & dosage; Doxorubicin - administration & dosage; Doxorubicin - analogs & derivatives; Emergencies; emergency laparotomy; enteropathy-associated T-cell lymphoma; Enteropathy-Associated T-Cell Lymphoma - diagnosis; Enteropathy-Associated T-Cell Lymphoma - drug therapy; Enteropathy-Associated T-Cell Lymphoma - pathology; Fatal Outcome; Female; Flow Cytometry; Humans; Intestinal Perforation - etiology; Kidney Neoplasms - surgery; Laparotomy; Multiple Organ Failure - etiology; Neoplasms, Second Primary - diagnosis; Neoplasms, Second Primary - drug therapy; Neoplasms, Second Primary - pathology; Nephrectomy; Omentum - pathology; Pleural Effusion - etiology; Pleural Effusion - therapy; Prednisolone - administration & dosage; Respiration, Artificial; Respiratory Insufficiency - etiology; Respiratory Insufficiency - therapy; Vincristine - administration & dosage
• ISSN: 0918-2918; 1349-7235; 1349-7235
• DOI: 10.2169/internalmedicine.53.1268

Enteropathy-associated T-cell lymphoma (EATL), an intestinal tumor of intraepithelial T lymphocytes, is a rare and highly aggressive disease. We herein describe a case of type II EATL with massive pyoid ascites in which a histological examination could not be performed despite emergency laparotomy that was successfully diagnosed using flow cytometry and the cell block technique to analyze the celomic fluid. This case suggests that EATL should be included in the differential diagnosis of pyoid ascites of unknown origin and that flow cytometry and the cell block technique of assessing celomic fluid are useful procedures for diagnosing EATL, especially in cases in which conducting a histological examination is impossible.