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BMJ Case Reports 2009; doi:10.1136/bcr.06.2008.0270
  • Reminder of important clinical lesson

Enteropathy associated T cell lymphoma: common in coeliac disease

  1. Gabrielle Christina Colleran1,
  2. Kevin Christopher Cronin2,
  3. Mary Casey3,
  4. Fadel Bennani4,
  5. Iqdam Tobbia4,
  6. Kevin Barry5
  1. 1
    Galway University Hospital, Surgery, Newcastle, Galway, Ireland
  2. 2
    Galway University Hospital, Cardio-Thoracic Surgery, Newcastle, Galway, Ireland
  3. 3
    Mayo General Hospital, Radiology, Castlebar, Mayo, Ireland
  4. 4
    Mayo General Hospital, Pathology, Castlebar, Mayo, Ireland
  5. 5
    Mayo General Hospital, Surgery, Castlebar, Mayo, Ireland
  1. collerangabrielle{at}hotmail.com
  • Published 23 February 2009

Summary

A 56-year-old male admitted with haematemesis and epigastric pain and severe weight loss on a background of coeliac disease. Computed tomography (CT) abdomen revealed a thickening of the mucosal folds of a short segment of jejunum. He deteriorated and had an exploratory laparotomy and bowel resection with side-side jejojejunal stapled anastomosis and extended right hemicolectomy and ileocolic anastomosis. Histology demonstrated multifocal high-grade malignant T cell lymphoma. Coeliac disease is a very common lifelong disorder. It is associated with osteoporosis, infertility, autoimmune disorders and increased risk of malignancy including an increased risk of non-Hodgkin’s lymphoma (NHL) especially of the T cell type. Enteropathy-type T cell lymphoma is associated with a very poor prognosis. There is significant evidence that adherence to a gluten-free diet decreases the risk of developing enteropathy-type T cell lymphoma and helps to prevent development of autoimmune diseases, diabetes mellitus and osteoporosis in patients with coeliac disease.

Footnotes

  • Competing interests: none.

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