Hepatosplenic T-cell lymphoma in a patient with Crohn's disease

Nat Rev Gastroenterol Hepatol. 2009 Jul;6(7):433-6. doi: 10.1038/nrgastro.2009.87.


Background: A 58-year-old man who had a 35-year history of Crohn's disease presented to our IBD center with a disease flare, pararectal fistulas and abscess formation. The patient had previously undergone ileocolic resection for a stenosis and his abscesses had been treated by surgical drainage. He had been taking azathioprine therapy for approximately 5.5 years and had received high-dose steroids. He had also previously taken metronidazole and antihypertensive medications.

Investigations: Physical examination, laboratory investigations including hemoglobin levels and white blood cell counts, genetic testing, CT, bone-marrow biopsy, immunophenotyping by fluorescence-activated cell sorting, polymerase chain reaction analyses, fluorescence in situ hybridization, sputum culture and diagnostic splenectomy.

Diagnosis: Hepatosplenic T-cell lymphoma.

Management: Splenectomy, antibiotic therapy and chemotherapy with cyclophosphamide.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antineoplastic Agents, Alkylating / therapeutic use
  • Crohn Disease / complications*
  • Crohn Disease / drug therapy
  • Cyclophosphamide / therapeutic use
  • Fatal Outcome
  • Humans
  • Liver Neoplasms / complications*
  • Liver Neoplasms / drug therapy
  • Liver Neoplasms / pathology
  • Lymphoma, T-Cell / complications*
  • Lymphoma, T-Cell / drug therapy
  • Lymphoma, T-Cell / pathology
  • Male
  • Middle Aged
  • Splenectomy
  • Splenic Neoplasms / complications*
  • Splenic Neoplasms / pathology
  • Splenic Neoplasms / surgery


  • Antineoplastic Agents, Alkylating
  • Cyclophosphamide