{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T05:20:37Z","timestamp":1763702437797,"version":"3.45.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"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. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Enteropathy associated T-cell lymphoma (EATL) is a rare and aggressive subtype of peripheral T-cell lymphoma, most commonly associated with celiac disease (CD). It typically presents with gastrointestinal symptoms and carries a poor prognosis. Cutaneous involvement as the initial manifestation, particularly in the form of refractory skin ulcers in young patients, is rare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>We report a 28-year-old male who presented with a one-year history of refractory, non-healing ulcers on the right foot and several years of chronic diarrhea, initially misdiagnosed and treated as a chronic infection in April 2019. Despite multiple antibiotic regimens, surgical debridement, and immunosuppressive therapy, the lesions progressed symmetrically to involve the right hand and left thigh. The patient underwent amputation of the right lower limb and right hand in October 2020. One month later, the patient developed acute peritonitis secondary to jejunal perforation. Laparotomy revealed a transmural tumor mass, and histopathological and immunohistochemical analyses confirmed EATL (CD3+\/CD103+\/TIA-1+\/GRANB+, CD5-\/CD8-, Ki-67 ~70%). The patient died of multiorgan failure three weeks postoperatively in December 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case underscores that EATL may manifest with widespread cutaneous ulcers more than one year before the onset of severe gastrointestinal symptoms. In patients with chronic diarrhea and refractory skin ulcers, celiac disease should be excluded, while cutaneous lesions should be recognized as potential paraneoplastic manifestations of an underlying lymphoma. Diagnostic delays\u2014driven by anchoring bias and insufficient tissue sampling\u2014are critical contributors to advanced disease at presentation and poor clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2025.1716730","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T05:15:51Z","timestamp":1763702151000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Enteropathy-associated t-cell lymphoma presenting as refractory cutaneous ulcers in a 28-year-old male: a case report and literature review"],"prefix":"10.3389","volume":"15","author":[{"given":"Dejie","family":"Zhao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quanlin","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zheng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanan","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhixin","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-01-643569","article-title":"The 2016 revision of the world health organization classification of lymphoid neoplasms","volume":"127","author":"Swerdlow","year":"2016","journal-title":"Blood"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2012.12.001","article-title":"Enteropathy associated t cell lymphoma in celiac disease: A large retrospective study","volume":"45","author":"Malamut","year":"2013","journal-title":"Dig Liver Dis"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2021.05.034","article-title":"Cancer risk in 47,241 individuals with celiac disease: A nationwide cohort study","volume":"20","author":"Lebwohl","year":"2022","journal-title":"Clin Gastroenterol Hepatol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-02-335216","article-title":"Enteropathy-associated t-cell lymphoma: Clinical and histological findings from the international peripheral t-cell lymphoma project","volume":"118","author":"Delabie","year":"2011","journal-title":"Blood"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1002\/jha2.1049","article-title":"Enteropathy-associated t-cell lymphoma: A population-based cohort study on incidence, treatment, and outcome in the Netherlands","volume":"5","author":"Meeuwes","year":"2024","journal-title":"EJHaem"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1002\/hon.2569","article-title":"Cutaneous manifestations of hematologic Malignancies the experience of an italian dermatology department","volume":"37","author":"Merlo","year":"2019","journal-title":"Hematol Oncol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2019.01.017","article-title":"Dermatologic aspects of systemic vasculitis","volume":"37","author":"Younger","year":"2019","journal-title":"Neurol Clin"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-10-385559","article-title":"How i treat enteropathy-associated t-cell lymphoma","volume":"119","author":"Di Sabatino","year":"2012","journal-title":"Blood"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-022-01613-1","article-title":"The 5th edition of the world health organization classification of haematolymphoid tumours: Myeloid and histiocytic\/dendritic neoplasms","volume":"36","author":"Khoury","year":"2022","journal-title":"leukemia"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.4103\/sjg.sjg_100_21","article-title":"Endoscopic features and clinical outcomes of enteropathy-associated t-cell lymphoma: A tertiary center retrospective study","volume":"28","author":"Chen","year":"2022","journal-title":"Saudi J Gastroenterology"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.23992","article-title":"Treatment response in enteropathy associated t-cell lymphoma; 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