Colleran Gabrielle Christina, Cronin Kevin Christopher, Casey Mary, Bennani Fadel, Tobbia Iqdam, Barry Kevin
Galway University Hospital, Surgery, Newcastle, Galway, Ireland.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.06.2008.0270. Epub 2009 Feb 23.
A 56-year-old male admitted with haematemesis and epigastric pain and severe weight loss on a background of coeliac disease. Computed tomography (CT) abdomen revealed a thickening of the mucosal folds of a short segment of jejunum. He deteriorated and had an exploratory laparotomy and bowel resection with side-side jejojejunal stapled anastomosis and extended right hemicolectomy and ileocolic anastomosis. Histology demonstrated multifocal high-grade malignant T cell lymphoma. Coeliac disease is a very common lifelong disorder. It is associated with osteoporosis, infertility, autoimmune disorders and increased risk of malignancy including an increased risk of non-Hodgkin's lymphoma (NHL) especially of the T cell type. Enteropathy-type T cell lymphoma is associated with a very poor prognosis. There is significant evidence that adherence to a gluten-free diet decreases the risk of developing enteropathy-type T cell lymphoma and helps to prevent development of autoimmune diseases, diabetes mellitus and osteoporosis in patients with coeliac disease.
一名56岁男性因呕血、上腹部疼痛和严重体重减轻入院，其患有腹腔疾病。腹部计算机断层扫描（CT）显示空肠短节段黏膜皱襞增厚。他病情恶化，接受了剖腹探查术、肠切除术，并行端端空肠吻合术、扩大右半结肠切除术及回结肠吻合术。组织学检查显示为多灶性高级别恶性T细胞淋巴瘤。腹腔疾病是一种非常常见的终身性疾病。它与骨质疏松症、不孕症、自身免疫性疾病以及包括非霍奇金淋巴瘤（NHL）尤其是T细胞型淋巴瘤在内的恶性肿瘤风险增加有关。肠病型T细胞淋巴瘤的预后非常差。有大量证据表明，坚持无麸质饮食可降低患肠病型T细胞淋巴瘤的风险，并有助于预防腹腔疾病患者自身免疫性疾病、糖尿病和骨质疏松症的发生。
