<<Disclaimer: Verify this information before applying it to your situation.>> 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.