title: Obstructive jaundice caused by enteropathy-associated T-cell lymphoma in a patient with celiac sprue.
abstract: Patients with celiac sprue carry a considerable risk of gastrointestinal malignancies; in particular, non-Hodgkin's lymphoma. These malignancies represent the most serious complications of celiac disease. Commonly, patients present with deteriorating symptoms of the underlying disease, which makes an early diagnosis difficult. We report a patient with a 13-year history of celiac sprue presenting with painless jaundice and a Courvoisier gallbladder. Abdominal computed tomography (CT) scan showed thickening of the duodenal wall, suggesting a neoplastic infiltration of the papilla of Vater, causing biliary obstruction. Biopsies taken on endoscopy revealed enteropathy-associated T-cell lymphoma of the duodenum. Biliary obstruction is a rare clinical finding in enteropathy-associated T-cell lymphoma. To our knowledge, this is the first reported case of this unusual manifestation in celiac disease.
authors.affiliation: Medizinische Universitätsklinik Kantonsspital Bruderholz, Bruderholz, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Buess
authors.forename: Michael
authors.initials: M
authors.lastname: Steuerwald
authors.forename: Werner
authors.initials: W
authors.lastname: Wegmann
authors.forename: Madeleine
authors.initials: M
authors.lastname: Rothen
mesh_terms: D001706:Biopsy; D002446:Celiac Disease / Q000150:complications*; D004379:Duodenal Neoplasms / Q000150:complications; D005705:Gallbladder Diseases / Q000150:complications; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology*; D016399:Lymphoma, T-Cell / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed