{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T05:59:32Z","timestamp":1780639172869,"version":"3.54.1"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To report a rare case of monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) presenting with acute gastrointestinal perforation and to describe the use of an exploratory regimen combining a BCL-2 inhibitor (Venetoclax) with CHOP chemotherapy, highlighting the diagnostic challenges and therapeutic considerations for this aggressive disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We detail the clinicopathological journey of a 72-year-old male patient who presented with an acute abdomen. The diagnosis was established through surgical pathology and comprehensive immunohistochemistry. Following an initial treatment refusal and a subsequent disease recurrence manifesting as a second perforation, the patient received Venetoclax combined with CHOP. The relevant literature was reviewed to inform the diagnostic and therapeutic decisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Emergency surgery for perforation revealed MEITL (initially staged as Lugano stage I). The patient initially declined therapy but presented 9\u202fmonths later with recurrent perforation, confirmed as disease relapse via pathology. Immunohistochemistry showed tumor cells were CD3 (weakly positive), CD8+, CD56+, Bcl-2 (3+), and Ki-67 (~60%). Postoperative PET\/CT revealed limited retroperitoneal lymph node involvement. The patient received four cycles of Venetoclax (200\u202fmg\/day, days 1\u201314) plus CHOP, achieving complete metabolic remission on follow-up PET\/CT without significant myelosuppression. The 9-month untreated interval despite high Ki-67 is noteworthy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MEITL is a highly aggressive lymphoma often presenting as a surgical emergency. Diagnosis relies on histopathology and a characteristic immunophenotype (CD3+ CD8+ CD56+). This case suggests that incorporating BCL-2 inhibition into the treatment of Bcl-2\u2013high MEITL may represent a biologically rational strategy. Besides, the prolonged untreated interval observed in this patient highlights the potential biological heterogeneity of MEITL. While the observed complete metabolic remission is encouraging, this finding remains hypothesis-generating and requires validation in larger studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1818999","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T05:00:54Z","timestamp":1780635654000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Monomorphic epitheliotropic intestinal T-cell lymphoma presenting as acute small intestinal perforation: a case report and exploratory BCL-2\u2013targeted therapy"],"prefix":"10.3389","volume":"13","author":[{"given":"Meijuan","family":"He","sequence":"first","affiliation":[{"name":"Department of Hematology, Xinghua People's Hospital Affiliated to Yangzhou University","place":["Taizhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Hematology, Xinghua People's Hospital Affiliated to Yangzhou University","place":["Taizhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Hematology, Xinghua People's Hospital Affiliated to Yangzhou University","place":["Taizhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Hematology, Xinghua People's Hospital Affiliated to Yangzhou University","place":["Taizhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjing","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Oncology, Xinghua People's Hospital Affiliated to Yangzhou University","place":["Taizhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoping","family":"Ye","sequence":"additional","affiliation":[{"name":"Shanghai DIAN Medical Laboratory Co., Ltd.","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihan","family":"Cai","sequence":"additional","affiliation":[{"name":"Nanjing Dian Diagnostics Group Co., Ltd.","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zefa","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Hematology, Xinghua People's Hospital Affiliated to Yangzhou University","place":["Taizhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1177\/0003134820943563","article-title":"Monomorphic epitheliotropic intestinal 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Rep"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1038\/s41409-025-02752-6","article-title":"Outcomes of hematopoietic stem cell transplantation for patients with monomorphic epitheliotropic intestinal T-cell lymphoma: retrospective study from the adult lymphoma working Group of the Japan Society for transplantation and cellular therapy","volume":"61","author":"Kuriyama","year":"2026","journal-title":"Bone Marrow Transplant"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"789891","DOI":"10.3389\/fonc.2021.789891","article-title":"Venetoclax shows low therapeutic activity in BCL2-positive relapsed\/refractory peripheral T-cell lymphoma: a phase 2 study of the Fondazione Italiana Linfomi","volume":"11","author":"Ballotta","year":"2021","journal-title":"Front Oncol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e31326","DOI":"10.1097\/MD.0000000000031326","article-title":"Pegylated liposomal doxorubicin (PLD)-containing regimen as a novel treatment of monomorphic epithelial intestinal T-cell lymphoma (MEITL): a case report and review of literature","volume":"101","author":"Chen","year":"2022","journal-title":"Medicine (Baltimore)"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"3000605241271756","DOI":"10.1177\/03000605241271756","article-title":"Monomorphic epitheliotropic intestinal T-cell lymphoma: report of four cases and literature review","volume":"52","author":"Ding","year":"2024","journal-title":"J Int Med Res"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1710764","DOI":"10.3389\/fonc.2026.1710764","article-title":"Case report: targeting the Achilles' heel of monomorphic epitheliotropic intestinal T-cell lymphoma","volume":"16","author":"Xue","year":"2026","journal-title":"Front Oncol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1898","DOI":"10.1182\/blood.2023021788","article-title":"Current and upcoming treatment approaches to uncommon subtypes of PTCL (EATL, MEITL, SPTCL, and HSTCL)","volume":"144","author":"Marchi","year":"2024","journal-title":"Blood"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e31951","DOI":"10.1097\/MD.0000000000031951","article-title":"Proteomics and genomics of a monomorphic epitheliotropic intestinal T-cell lymphoma: an extremely rare case report and short review of literature","volume":"101","author":"Bo\u0219oteanu","year":"2022","journal-title":"Medicine (Baltimore)"}],"container-title":["Frontiers in 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