Abdominal computed tomography in refractory coeliac disease and enteropathy associated T-cell lymphoma.
OBJECTIVE
To evaluate computed tomography (CT) findings, useful to suggest the presence of refractory celiac disease (RCD) and enteropathy associated T cell lymphoma (EATL).


METHODS
Coeliac disease (CD) patients were divided into two groups. Group I: uncomplicated CD (n = 14) and RCD type I (n = 10). Group II: RCD type II (n = 15) and EATL (n = 7).


RESULTS
Both groups showed classic signs of CD on CT. Intussusception was seen in 1 patient in group I vs 5 in group II (P = 0.06). Lymphadenopathy was seen in 5 patients in group II vs no patients in group I (P = 0.01). Increased number of small mesenteric vessels was noted in 20 patients in group I vs 11 in group II (P = 0.02). Eleven patients (50%) in group II had a splenic volume < 122 cm3 vs 4 in group I (14%), 10 patients in group I had a splenic volume > 196 cm3 (66.7%) vs 5 in group II (33.3%) P = 0.028.


CONCLUSIONS
CT scan is a useful tool in discriminating between CD and (Pre) EATL. RCD II and EATL showed more bowel wall thickening, lymphadenopathy and intussusception, less increase in number of small mesenteric vessels and a smaller splenic volume compared with CD and RCD I.
Mallant
Maarten
M
Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands.
Hadithi
Muhammed
M
Al-Toma
Abdul-Baqi
AB
Kater
Matthijs
M
Jacobs
Maarten
M
Manoliu
Radu
R
Mulder
Chris
C
van Waesberghe
Jan-Hein
JH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002446:Celiac Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007422:Intestines / Q000000981:diagnostic imaging / Q000473:pathology; D016399:Lymphoma, T-Cell / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008643:Mesentery / Q000098:blood supply; D008875:Middle Aged; D009929:Organ Size; D011860:Radiography, Abdominal / Q000379:methods; D013154:Spleen / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods*