Indolent T-cell lymphoproliferative disorder of the gastrointestinal tract managed conservatively with corticosteroids

An 82-year-old female presented with a 4-week history of abdominal pain, weight loss, diarrhea, and nausea. A complete infectious workup was negative. Her computed tomography (CT) scan showed no pathologic changes and her esophagogastroduodenoscopy (EGD) showed erosive damage in the duodenum. Her duodenal biopsy showed inflammation with a marked increase in intra-epithelial lymphocytes and her immunohistochemistry was consistent with indolent T-cell lymphoproliferative disorder of the gastrointestinal tract. She was started on high dose steroids three months after the onset of her symptoms. She gradually improved with complete resolution of erosive changes on her repeat EGD.