Rubio-Tapia Alberto, Hernández-Calleros Jorge, Trinidad-Hernández Sagrario, Uscanga Luis
Department of Gastroenterology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga 15, Tlalpan 14000, Distrito Federal, Mexico.
World J Gastroenterol. 2006 Mar 28;12(12):1945-8. doi: 10.3748/wjg.v12.i12.1945.
To describe the clinical and histological characteristics of a group of adults with small-bowel nodular lymphoid hyperplasia (NLH).
Patients were searched for five years in pathology records of our institution. The biopsy material was reassessed using strict histopathological criteria. Clinical data were obtained from medical records.
Small-bowel NLH was diagnosed in 18 cases. The female: male ratio was 2:1. The most frequent symptoms were diarrhea (72%), involuntary weight loss (72%) and abdominal pain (61%). Nine patients (50%) had immunodeficiency. Small-bowel bacterial overgrowth was found in three (17%) cases. At small-bowel NLH diagnosis, three (17%) had associated lymphoma: two intestinal and one extra-intestinal lymphomas. In two patients with villous atrophy and anti-endomysial antibodies the diagnosis of celiac disease was established. Giardia lamblia infection was found in only one patient with hypogammaglobulinemia (Herman's syndrome).
NLH is uncommon in adult patients. Associated diseases are immunodeficiency and lymphoid tissue malignancies.