Hypereosinophilia with Eosinophilic colitis as First Manifestation of Peripheral T Cell Lymphoma: A Case Report

Peripheral T cell Lymphoma (PTCL) is a rare variety of nonHodgkin's Lymphoma with poor prognosis. Besides lymphadenopathy, this malignancy can present with different atypical features, which may baffle clinicians. We here present the case of a 59 year old male who presented with chronic diarrhoea. This was proved to be eosinophilic colitis on colonoscopy. Later, he developed peripheral hypereosinophilia (absolute eosinophil count: 36252/µL) and abdominal lymphadenopathy (mainly retroperitoneal and right iliac). Biopsy and immunophenotyping from the lymph nodes proved this to be a case of PTCL. The patient also had eosinophilic pleural effusion and ascites. He was started on E-CHOP chemotherapy, which led to complete reversal of the peripheral eosinophilia. The eosinophilic colitis responded partially to steroids. Hypereosinophilia has been reported in PTCL but such eosinophilic colitis and eosinophilic pleural effusion are extremely rare.