Is adult-onset coeliac disease due to a low-grade lymphoma of intraepithelial T lymphocytes?
Enteropathy-associated T-cell lymphoma commonly presents with malabsorption, and debate continues as to whether adult-onset coeliac disease (CD) is itself a form of low-grade lymphoma. A 59-year-old man with adult-onset CD required resection of a segment of oedematous jejunum. Histological examination of this tissue revealed an intense intraepithelial lymphocytosis. Immunophenotypic (CD3-, CD4-, CD8-, CD34-, and CD45 RO-) and cytogenetic (deletion of the Y chromosome and chromosome 9) abnormalities were found, together with monoclonal T-cell-receptor gene rearrangements. Some patients with adult-onset CD may have low-grade lymphoma from the outset of their illness.
Wright
D H
DH
Department of Pathology, Southampton General Hospital, UK.
Jones
D B
DB
Clark
H
H
Mead
G M
GM
Hodges
E
E
Howell
W M
WM
D001706:Biopsy; D002446:Celiac Disease / Q000209:etiology* / Q000235:genetics / Q000473:pathology; D015329:Gene Rearrangement, T-Lymphocyte / Q000235:genetics; D006801:Humans; D007579:Jejunal Diseases / Q000209:etiology* / Q000235:genetics / Q000473:pathology; D008206:Lymphatic Diseases / Q000209:etiology* / Q000235:genetics / Q000473:pathology; D016399:Lymphoma, T-Cell / Q000150:complications* / Q000235:genetics / Q000473:pathology; D008297:Male; D008875:Middle Aged