Bardella M T, Trovato C, Quatrini M, Conte D
Institute of Medical Science, IRCSS Ospedale Maggiore, Milan, Italy.
Scand J Gastroenterol. 1999 Dec;34(12):1257-9. doi: 10.1080/003655299750024805.
The cavitation of mesenteric lymph nodes represents a rare complication of celiac disease (only 30 reported cases) whose pathogenesis remains to be clarified. We here report the case of a 67-year-old woman referred to us because of a malabsorption syndrome lasting for 2 years; massive lymph node enlargement and cavitation were detected by means of ultrasonography and a computed tomography scan. Celiac disease was definitely diagnosed by means of duodenal histology, and a laparotomy was performed to exclude an underlying T-cell lymphoma. The adoption of a gluten-free diet led to a rapid and dramatic improvement in the clinical and histologic picture and normalization of the size of the lymph nodes. Celiac disease should be considered in the differential diagnosis of all patients with mesenteric lymph node cavitation.
肠系膜淋巴结空洞形成是乳糜泻的一种罕见并发症（仅报道过30例），其发病机制尚待阐明。我们在此报告一例67岁女性患者，因持续2年的吸收不良综合征前来就诊；通过超声检查和计算机断层扫描检测到大量淋巴结肿大和空洞形成。通过十二指肠组织学检查明确诊断为乳糜泻，并进行了剖腹手术以排除潜在的T细胞淋巴瘤。采用无麸质饮食后，临床和组织学表现迅速显著改善，淋巴结大小恢复正常。对于所有肠系膜淋巴结空洞形成的患者，鉴别诊断时均应考虑乳糜泻。
