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World J Gastroenterol. 2016 Dec 21;22(47):10465-10470. doi: 10.3748/wjg.v22.i47.10465.

Hepatosplenic T-cell lymphoma in a 47-year-old Crohn's disease patient on thiopurine monotherapy.

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Maartje M van de Meeberg, Lauranne AAP Derikx, D Lucette Schipper, Loes HC Nissen, Department of Gastroenterology and Hepatology, Jeroen Bosch Hospital, 5200 ME 's-Hertogenbosch, The Netherlands.


Hepatosplenic T-cell lymphoma (HSTCL) is a rare non-Hodgkin lymphoma with a high mortality rate. Higher incidence is reported in patients with inflammatory bowel disease, specifically in male patients that are younger than 35 years, and have been treated with thiopurine and tumor necrosis factor (TNF)-α inhibitor combination therapy for over 2 years. In this case report we describe a 47-year-old patient with Crohn's disease (CD) who developed HSTCL after having been treated with thiopurine monotherapy for 14 years. To our best knowledge, only eleven cases exist of patients with CD who developed HSTCL while on thiopurine monotherapy. We report the first patient with CD, older than 35 years, who developed HSTCL while on thiopurine monotherapy. This emphasizes that HSTCL risk is not limited to young men receiving both thiopurines and TNF-α inhibitors.


Crohn’s disease; Hepatosplenic T-cell lymphoma; Immunosuppression; Thiopurine

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