Linfoma anaplásico de grandes células T com envolvimento do cólon. Relato de caso

JUSTIFICATIVA E OBJETIVOS: Linfoma anaplasico de grandes celulas e um tipo raro de linfoma nao-Hodgkin (LNH) originado de linfocitos T maduros. O diagnostico e feito a partir de quadro morfologico tipico e de um imunofenotipo de celulas T positivo para CD30. As lesoes gastrintestinais sao os tipos mais comum de linfomas extranodais primarios, representando cerca de 5% a 10% de todos os LNH, sendo mais comum no fenotipo de celulas B. O objetivo deste relato foi descrever um caso com envolvimento primario do colon, evoluindo rapidamente para a fase terminal, com falencia multipla de orgaos e sistemas. RELATO DO CASO: Paciente do sexo masculino, 50 anos, admitido no servico de Clinica Medica do Hospital Santa Casa do Rio Grande (ACSCRG) com historia de dor abdominal inespecifica ha dois meses. Havia realizado endoscopia digestiva alta e recebeu tratamento, ao final do qual desenvolveu lesoes cutâneas eritematosas difusas, que motivaram sua admissao para investigacao.Febril, com abdomen levemente distendido e figado palpavel. Na videocolonoscopia identificou-se placas arredondadas de mucosa escurecida com 4 a 6 mm em meio a mucosa normal, estendendo-se ate o ileo terminal. CONCLUSAO: O linfoma anaplasico de grandes celulas e raro e infrequente em descricoes e revisoes. Tipo raro de LNH apresenta-se com comportamento agressivo, em estagio avancado e frequentemente com localizacao extranodal. A localizacao gastrica e a mais encontrada, seguida pelo intestino delgado. BACKGROUND AND OBJECTIVES: Anaplastic large cell lymphoma is a rare type of non-Hodgkin lymphoma originated from mature T lymphocytes. The diagnosis is made from the recognition of typical morphological features and a CD30-positive T-cell immunophenotype. The gastrointestinal lesions are the most common type of primary extranodal lymphomas, accounting for about 5% to 10% of all NHLs, being more common in B-cell phenotype. The purpose of this report describes a case with primary involvement of the colon, rapidly progressing to the terminal phase, with the multiple organ dysfunction syndrome.CASE REPORT: A 50-year-old man admitted to the Internal Medicine ward at the, Hospital Santa Casa do Rio Grande (ACSCRG) with a history of nonspecific abdominal pain for two months. Endoscopy had been undertaken and he received treatment, at the end of which he developed diffuse erythematous skin lesions, which motivated admission for investigation. Investigation,feverish, with slightly distended abdomen and palpable liver. Through colonoscopy it was identified rounded plaques of darkened mucosal with 4 to 6 mm among the of normal mucosa, extending to the terminal ileum. CONCLUSION: Anaplastic large cell lymphoma is rare and infrequent in descriptions and reviews. Rare type of non-Hodgkin lymphoma (NHL), this disease presents itself with an aggressive course, advanced stage, and often extranodal location. The gastric location is the most common, followed by the small intestine.