Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is a rare and aggressive primary intestinal lymphoma with a poor prognosis. MEITL can metastasize to the central nervous system, liver and spleen, but gallbladder involvement has not yet been reported. The present study describes the case of a 57-year-old woman who presented with abdominal distention, pain and vomiting. Contrast-enhanced computed tomography revealed thickening and perforation of the small intestinal wall, and a gallbladder mass. Histopathological analysis of the affected small intestine and gallbladder revealed a dense infiltrate of medium-sized monomorphic lymphocytes with a CD3+, CD4-, CD8+ and TIA-1+ phenotype. Based on the absence of celiac disease, aggressive clinical course, and characteristic histopathological and immunophenotypic features, a diagnosis of MEITL with gallbladder involvement was established. The patient underwent small intestinal resection and cholecystectomy, followed by chemotherapy, which was completed without gastrointestinal or gallbladder perforation. Diagnostic resection is currently the best approach for suspected malignant lymphoma of the gallbladder. This rare case of MEITL with gallbladder involvement highlights the importance of considering this diagnosis in similar clinical scenarios and the role of cholecystectomy, which can serve both diagnostic and therapeutic purposes.
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