Hepatosplenic T-cell lymphoma in a patient with Crohn's disease

Background. a 58-year-old man who had a 35-year history of Crohn's disease presented to our IBD center with a disease flare, pararectal fistulas and abscess formation. the patient had previously undergone ileocolic resection for a stenosis and his abscesses had been treated by surgical drainage. He had been taking azathioprine therapy for approximately 5.5 years and had received high-dose steroids. He had also previously taken metronidazole and antihypertensive medications. Investigations. Physical examination, laboratory investigations including hemoglobin levels and white blood cell counts, genetic testing, CT, bone-marrow biopsy, immunophenotyping by fluorescence-activated cell sorting, polymerase chain reaction analyses, fluorescence in situ hybridization, sputum culture and diagnostic splenectomy. Diagnosis. Hepatosplenic T-cell lymphoma. Management. splenectomy, antibiotic therapy and chemotherapy with cyclophosphamide.