(EOSINOPHILIA-LEADING SYMPTOM OF AN ENTER OPATHY-ASSOCIATED T-CELL LYMPHOMA OF HIGH MALIGNANCY)

A 39 year old man had been suffering from chronic bowel symptoms of ch anging intensity. At the age of 37 the diagnosis of nontropical sprue was made. After institution of a gluten free diet the patient improved , but soon diarrhea started again. In the examination of peripheral bl ood smear, bone marrow and small intestinal mucosal biopsies a dominan t eosinophilia was found. Since several attacks of abdominal colics an d finally an acute abdomen occured, a laparotomy was indicated. This o perative intervention showed a perforation of the intestine and tumors in the bowel wall as well as numerous lymphomas spread over the whole mesentery. The histological examination of both the small intestine r esect and the lymphomas proved the diagnosis of a highly malignant Non Hodgkin lymphoma (middle and large cell pleomorphic T-cell lymphoma w ith transition into a large cell anaplastic lymphoma [ki-1 lymphoma]). The patient received a chemotherapy with COEP, but died 4 weeks after the surgery.