• Hanxin Bi, Junfang Bai, Limei Wang, Cong Liang, and Ying Wu.
• The Second People's Hospital of Shaanxi Province, Xi'an, Shaanxi Province, China.
• Medicine (Baltimore). 2024 Jun 7; 103 (23): e38465e38465.

RationaleIntestinal T-cell lymphomas are exceedingly rare diseases. Intestinal T-cell lymphoma NOS, as a "wastebasket" category, is difficult to diagnosis. Endoscopy can identify abnormal mucosa in most patients at a reasonably early stage. Therefore, it is crucial to increase the understanding of endoscopists in terms of the endoscopic characteristics of ITCL.Patient ConcernsA 74-year-old male alone with wasting as the major complaint, had multiple polypoid lesions in the large intestine. The patient then had endoscopic care.DiagnosesOnly 1 polypoid lesion on white-light endoscopy in the sigmoid colon was pathologically diagnosed as intestinal T-cell lymphomas, not otherwise specified (ITCL-NOS).InterventionsThe patient underwent intensity-reduced CHOP therapy.OutcomesThe patient is still with controlled disease but developed chemotherapy-related side effects.LessonsIn the individual with unexplained anemia and waste, endoscopy should not be delayed. For each of polypoid lesion on white-light endoscopy, the endoscopist need to remain cautious, because every lesion in the same patient can exhibit the independence of histopathological features. Meanwhile, we suggest that endoscopists should routinely observe the terminal ileum, even take biopsy samples if necessary.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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