Small bowel (small intestine)
Enteropathy associated T cell lymphoma (EATL)

Author: Hanni Gulwani, M.D. (see Authors page)

Revised: 22 February 2018, last major update August 2012

Copyright: (c) 2003-2018,, Inc.

PubMed Search: Enteropathy associated T cell lymphoma small bowel

Cite this page: Gulwani, H. Enteropathy associated T cell lymphoma (EATL). website. Accessed November 20th, 2018.
Definition / general
  • Intestinal tumour of intraepithelial T lymphocytes composed of large, often polymorphic lymphoid cells, which are negative for CD56 (IARC: 9717 / 3 Intestinal T Cell Lymphoma [Accessed 22 February 2018])
  • Associated with long standing malabsorption (mean 28 years) that ceases to be gluten sensitive
  • 14% incidence in celiac sprue patients
  • Abdominal pain, clubbing, fever, hemorrhage, intestinal obstruction, perforation, ulceration of bowel, weight loss; also sustained increase in serum IgA
  • Ulceration may coincide with or precede detectable lymphoma but it is difficult to rule out lymphoma (unless have multiple biopsies) since it may be focal
  • 75% dead within 2 years
Gross description
  • Widespread patchy involvement, often of small bowel, associated with ulceration, stricture, perforation
Microscopic (histologic) description
  • May require 20 tissue sections to diagnose malignancy since tumor is so focal

WHO classification:

Type I (celiac associated):
  • Variable lymphomatous infiltrate with neoplastic large cells with conspicuous nucleoli
  • May have pleomorphic, multinucleated cells
  • Also small to medium sized lymphocytes, histiocytes and eosinophils
  • Adjacent mucosa shows villous atrophy, crypt hyperplasia, increased inflammatory cells in lamina propria, intraepithelial lymphocytosis

Type II (no history of celiac sprue):
  • Lymphomatous infiltrate is homogeneous and composed of small to medium sized lymphocytes with a rim of pale or clear cytoplasm, slightly irregular nuclei and small nucleoli; CD8+, CD56+
  • Villous atrophy, blunting and intraepithelial lymphocytosis confined to area of lymphoma
  • More distant nonlymphomatous mucosa is unremarkable
Microscopic (histologic) images

Images hosted on other servers:

Various images

Positive stains
Negative stains
Additional references