Coexistence of monomorphic epitheliotropic intestinal T-cell lymphoma of the jejunum and bilateral adrenal pheochromocytomas: A case report.

Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is rare and aggressive form of intestinal lymphoma. We report a 52-year-old man with coexisting MEITL of the jejunum and bilateral adrenal pheochromocytomas. PET-CT revealed a small jejunal mass with intestinal wall thickening (SUVmax: 21) and bilateral adrenal lesions (SUVmax: 10). Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) showed restricted diffusion in the jejunal mass [Apparent diffusion coefficient (ADC): 0.71 × 10-3 cm/sec] and adrenal lesions (ADC: 1.2 × 10-3 cm/sec). Bilateral adrenal masses demonstrated I-123 MIBI uptake, consistent with pheochromocytomas. Simultaneous resection of the jejunal and bilateral adrenal tumors was performed. Pathological diagnoses were MEITL of the jejunum without lymph node involvement and benign bilateral adrenal pheochromocytomas. Despite prompt diagnosis and treatment, the patient died 9 months after initial presentation. This case underscores the importance of recognizing MEITL even when imaging findings appear mild and highlights the utility of PET-CT and DWIBS in its evaluation.