Buess Martin, Steuerwald Michael, Wegmann Werner, Rothen Madeleine
Medizinische Universitätsklinik Kantonsspital Bruderholz, Bruderholz, Switzerland.
J Gastroenterol. 2004 Nov;39(11):1110-3. doi: 10.1007/s00535-004-1453-3.
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.
