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Here are some abstracts regarding t-cell lymphoma and celiac disease.
Lymphoma can present with NO symptoms, as in my husband's case.    -Kelly
in Michigan

Malignant lymphoma in coeliac disease: various manifestations with distinct
symptomatology and prognosis

Mathus-Vliegen EM, Van Halteren H, Tytgat GN

Department of Gastroenterology, Academic Medical Centre, University of
Amsterdam, The Netherlands.

OBJECTIVES. To study the different forms of malignant lymphoma complicating
coeliac disease in a low-prevalence area, according to extranodal-nodal and
extraintestinal-intestinal manifestations. SUBJECTS AND SETTING. Patients
recruited from two University Hospitals (Amsterdam, Leiden) and from PALGA
(National Dutch data-bank) over a 16-year period. DESIGN. Review of
hospital charts with respect to clinical presentation and treatment of both
coeliac disease and malignant lymphoma. Re-evaluation of morphology and
staging by immunoperoxidase, enzyme- and immunohistochemical stainings on
unstained and frozen materials. MAIN OUTCOME MEASURES. Clinical behaviour
and T- or B-cell morphology of extranodal intestinal, extranodal
extraintestinal and nodal intestinal disease. RESULTS. Fourteen cases of
enteropathy-associated lymphoma could be traced, 10 with a history of
coeliac disease, four primarily presenting with malignant lymphoma. The
usual extranodal intestinal lymphoma (eight cases) presented with abdominal
pain, weight loss, and malabsorption. Six had atypical disease: four
presented with extranodal extraintestinal disease, located in the skin or
the respiratory tract; two patients had intractable malabsorption and
oedema caused by a nodal intestinal lymphoma. Re-evaluation with additional
immunohistochemical stainings in 11 patients showed a pleomorphic malignant
infiltrate of histiocyte-like cells of T-cell origin, with a pattern of
CD3+; CD4-; CD5 +/-; CD7+ and CD8-. It also established a more appropriate
diagnosis in four, an 0.6-year earlier diagnosis in six, and an upgraded
stage of disease in two patients. A more extensive spread and poorer
outcome appeared to become more probable in the ranking order of extranodal
intestinal, extranodal extraintestinal and nodal intestinal lymphoma.
CONCLUSIONS. A proper and timely diagnosis of enteropathy-associated
lymphoma requires clinical vigilance and unrelentless perseverance to
obtain adequate fresh and frozen tissue for histochemical staining. Further
research in a larger number of patients is warranted to investigate the
relation between the primary site of the lymphoma, i.e. extranodal
intestinal, extranodal extraintestinal, or nodal intestinal, and (its
impact on) clinical presentation and prognosis.


Coeliac disease and malignancies.

Ferguson A, Kingstone K

Department of Medicine, Western General Hospital, University of Edinburgh, UK.

When compared with the general population, patients with coeliac disease
(CD) have an increased risk of developing enteropathy-associated T-cell
lymphoma (EATCL), esophageal and pharyngeal squamous carcinomas and small
intestinal adenocarcinomas. The prevalence of histologically confirmed CD
in Edinburgh and the Lothians in 1979 was 61 per 100,000. The National
Health Service Central Records of all 653 subjects registered at that time
have been flagged, allowing us to analyse mortality in CD. At a mean of
13.5 years, mortality overall was 1.9-fold that of the general population
(115 deaths observed. 61.8 expected; p < 0.0001). For both sexes the early
mortality was much greater than expected, but the excess steadily
diminished with time from diagnosis. Much of the increased mortality from
malignant disease was accounted for by deaths from lymphoproliferative
disease and esophageal cancer. Interim re-analysis after a further 9 years
shows that the pattern of later deaths is consistent with these trends.
Clinical and pathological features of lymphomas in CD are described. In
serum samples of 41 patients with normal villus architecture while taking a
normal diet, but with minor pathological and/or immunological
abnormalities, i.e. potential CD, IgA antiendomysium antibodies were
positive in 7 with dermatitis herpetiformis but in only 3 others.