Cutaneous Manifestation of Monomorphic Epitheliotropic Intestinal T-Cell Lymphoma: A Clue to A Gastrointestinal Malignancy.
Fan Foon Cheo, Aashna Farishta, Briana M Garcia et al.
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Case in brief
A 68-year-old man presented with multiple purpuric patches from his axilla to groin, leading to a diagnosis of primary cutaneous cytotoxic T-cell lymphoma after skin biopsy. One year later, he developed oral lesions and jejunal perforation, with biopsies revealing similar atypical T-lymphocytes. Ultimately, he was diagnosed with monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL), highlighting the cutaneous manifestations of this condition.
What made this case unusual
The case illustrates cutaneous involvement of MEITL, which is exceedingly uncommon, emphasizing the need for awareness of this association in dermatological evaluations.
Diagnostic / clinical pearl
Clinicians should consider monomorphic epitheliotropic intestinal T-cell lymphoma in the differential diagnosis of dermal-based lymphomas with slight epidermotropism, especially when atypical CD8+/CD56+/TCR-δ-/EBER- T-lymphocytes are present.
Why it matters
This case highlights the importance of early endoscopic evaluation in patients with cutaneous manifestations, as it may reveal underlying gastrointestinal malignancies that are not detected through conventional staging.