Is adult-onset coeliac disease due to a low-grade lymphoma of intraepithelial T lymphocytes?

Lancet. 1991 Jun 8;337(8754):1373-4. doi: 10.1016/0140-6736(91)93059-i.


Enteropathy-associated T-cell lymphoma commonly presents with malabsorption, and debate continues as to whether adult-onset coeliac disease (CD) is itself a form of low-grade lymphoma. A 59-year-old man with adult-onset CD required resection of a segment of oedematous jejunum. Histological examination of this tissue revealed an intense intraepithelial lymphocytosis. Immunophenotypic (CD3-, CD4-, CD8-, CD34-, and CD45 RO-) and cytogenetic (deletion of the Y chromosome and chromosome 9) abnormalities were found, together with monoclonal T-cell-receptor gene rearrangements. Some patients with adult-onset CD may have low-grade lymphoma from the outset of their illness.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biopsy
  • Celiac Disease / etiology*
  • Celiac Disease / genetics
  • Celiac Disease / pathology
  • Gene Rearrangement, T-Lymphocyte / genetics
  • Humans
  • Jejunal Diseases / etiology*
  • Jejunal Diseases / genetics
  • Jejunal Diseases / pathology
  • Lymphatic Diseases / etiology*
  • Lymphatic Diseases / genetics
  • Lymphatic Diseases / pathology
  • Lymphoma, T-Cell / complications*
  • Lymphoma, T-Cell / genetics
  • Lymphoma, T-Cell / pathology
  • Male
  • Middle Aged