title: On the pathogenesis and clinical course of mesenteric lymph node cavitation and hyposplenism in coeliac disease.
abstract: BACKGROUND
  Coeliac disease is a disorder characterised by malabsorption related to abnormal small bowel structure and intolerance to gluten. There are several reports of an increased risk for malignancy in coeliac disease and its relation to gluten-free, reduced gluten, or normal diet. While a normal diet is associated with an excess of cancer of the mouth, pharynx, oesophagus, and also of lymphoma, treatment with a gluten-free diet restores the cancer risk back to normal.
  
  
  METHODS
  In the present study, we report on a 63-year-old female patient with a history of coeliac disease for twenty years who presented with persistent diarrhoea, weight loss, and an abdominal mass.
  
  
  RESULTS
  The gastroenterological work-up revealed small bowel mucosal atrophy, absence of functional splenic tissue, and evidence for an involution of a mesenteric lymph node, termed cavitation.
  
  
  CONCLUSIONS
  This triad has been previously described to represent a rare disease entity related to coeliac disease. We report a two-year follow-up and a review of the literature on the pathogenesis, prognosis, and therapeutical implications of this disease entity.
authors.affiliation: Department of Medicine 1, Ruhr-University Bochum, Germany. frank.schmitz@uni-bochum.de
authors.forename: Frank
authors.initials: F
authors.lastname: Schmitz
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Herzig
authors.forename: Eckhard
authors.initials: E
authors.lastname: Stüber
authors.forename: Markus
authors.initials: M
authors.lastname: Tiemann
authors.forename: Axel
authors.initials: A
authors.lastname: Reinecke-Lüthge
authors.forename: Rolf
authors.initials: R
authors.lastname: Nitsche
authors.forename: Ulrich R
authors.initials: UR
authors.lastname: Fölsch
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001707:Biopsy, Needle; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D004032:Diet; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007413:Intestinal Mucosa / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D008206:Lymphatic Diseases / Q000150:complications / Q000473:pathology* / Q000628:therapy; D008875:Middle Aged; D012720:Severity of Illness Index; D013158:Splenic Diseases / Q000150:complications / Q000473:pathology* / Q000628:therapy; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents