A Case Report of Primary Jejunal T-Lymphoblastic Lymphoma and a Review of the Literature

We report a 29-year-old male who developed primary jejunal T-Lymphoblastic Lymphoma (T-LBL). The patient was admitted to our hospital due to epigastralgia and back pain. An abdominal contrastenhanced Computed Tomography (CT) showed thickness of jejunal wall and enlargement of perijejunal lymph nodes. A gastrointestinal endoscopy showed an ulcerative tumor with bleeding at proximal end of jejunum beyond the Treitz ligament. A 18F-Fluorodeoxyglucose (FDG) -positron emission tomography/CT showed abnormal FDG uptake in jejunum, peri-jejunum lymph nodes, and left supraclavicular fossa lymph node as well as mediastinal and para-aortic lymph nodes. The tumor biopsy revealed middle to large sized abnormal lymphoblasts’ proliferation which were positive for CD3, CD5, CD10, CD79a, BCL2, and TdT, and negative for CD4, CD8, and CD20. We diagnosed him with T-LBL (Lugano stage IV). After administration of three courses of alternating hyper-CVAD with high-dose methotrexate and cytarabine he underwent umbilical cord blood transplantation at 1st Complete Remission (CR) and has maintained CR for more than 33 months. Intestinal T-LBL is very rare and has poor prognosis. To understand this disease, accumulating each case precisely and further investigation are very important.