{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:04:01Z","timestamp":1756425841382,"version":"3.44.0"},"reference-count":7,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,3,10]]},"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:p>We report an unusual case of a woman in her 60s diagnosed with monomorphic epitheliotropic intestinal T-cell lymphoma who required a pancreatoduodenectomy (Whipple procedure) for duodenal obstruction. The patient was initially treated with several cycles of chemotherapy, with persistent disease of the duodenum at D3. She was symptomatic with obstructive symptoms and positron emission tomography (PET)-CT showed disease localised to the duodenum without evidence of active disease elsewhere. The patient underwent pancreatoduodenectomy for both palliation of obstructive symptoms and potential oncological benefit. The patient had mild symptoms of delayed gastric emptying requiring promotility agents postoperatively, but otherwise recovered well after surgery. Unfortunately, surgical pathology revealed diffuse disease through the resected portion of the duodenum and jejunum, with positive proximal and distal margins. We suspect she has diffuse small bowel disease which was occult by CT and PET-CT. Based on this case, we recommend consideration of bypass rather than resection when possible for surgical palliation due to likelihood for extensive bowel involvement.<\/jats:p>","DOI":"10.1136\/bcr-2022-248948","type":"journal-article","created":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T11:50:15Z","timestamp":1647949815000},"page":"e248948","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Pancreatoduodenectomy for monomorphic epitheliotropic intestinal T-cell lymphoma with duodenal obstruction"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6204-8654","authenticated-orcid":false,"given":"Elizabeth J","family":"Olecki","sequence":"first","affiliation":[{"name":"Department of General Surgery, Pennsylvania State University, College of Medicine, Hershey, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin L","family":"Rakszawski","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1891-4199","authenticated-orcid":false,"given":"June S","family":"Peng","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, Penn State College of Medicine, Hershey, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,3,22]]},"reference":[{"key":"2025082803424892000_15.3.e248948.1","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1007\/s12328-021-01417-3","article-title":"Small bowel T-cell lymphoma: a MEITL-ing diagnosis","volume":"14","author":"Mago","year":"2021","journal-title":"Clin J Gastroenterol"},{"key":"2025082803424892000_15.3.e248948.2","doi-asserted-by":"crossref","first-page":"2541","DOI":"10.1007\/s00277-019-03791-y","article-title":"Multicenter retrospective analysis of the clinicopathologic features of monomorphic epitheliotropic intestinal T-cell lymphoma","volume":"98","author":"Yi","year":"2019","journal-title":"Ann Hematol"},{"key":"2025082803424892000_15.3.e248948.3","first-page":"680","article-title":"Presence of clonal T-cell receptor gene rearrangements provides evidence of widespread intramucosal intestinal T-cell lymphoma","volume":"34","author":"Schmitt-Gr\u00e4ff","year":"1996","journal-title":"Z Gastroenterol"},{"key":"2025082803424892000_15.3.e248948.4","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1016\/j.htct.2020.04.005","article-title":"Monomorphic epitheliotropic intestinal T-cell lymphoma of the duodenum: an aggressive disease","volume":"43","author":"Kasinathan","year":"2021","journal-title":"Hematology, Transfusion and Cell Therapy"},{"key":"2025082803424892000_15.3.e248948.5","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1186\/s13045-017-0452-9","article-title":"The diagnosis and management of NK\/T-cell lymphomas","volume":"10","author":"Tse","year":"2017","journal-title":"J Hematol Oncol"},{"key":"2025082803424892000_15.3.e248948.6","doi-asserted-by":"crossref","first-page":"516","DOI":"10.5009\/gnl.2012.6.4.516","article-title":"A case of enteropathy-type T-cell lymphoma diagnosed by small bowel enteroscopy: a perspective on imaging-enhanced endoscopy","volume":"6","author":"Bae","year":"2012","journal-title":"Gut Liver"},{"key":"2025082803424892000_15.3.e248948.7","doi-asserted-by":"crossref","DOI":"10.1186\/s13000-016-0519-x","article-title":"Multiple lesions of gastrointestinal tract invasion by monomorphic epitheliotropic intestinal T-cell lymphoma, accompanied by duodenal and intestinal enteropathy-like lesions and microscopic lymphocytic proctocolitis: a case series","volume":"11","author":"Ishibashi","year":"2016","journal-title":"Diagn Pathol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-248948","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:42:58Z","timestamp":1756377778000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-248948"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3]]},"references-count":7,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,3,22]]},"published-print":{"date-parts":[[2022,3]]}},"alternative-id":["10.1136\/bcr-2022-248948"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-248948","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2022,3]]}}}