Abdominal computed tomography in refractory coeliac disease and enteropathy associated T-cell lymphoma

World J Gastroenterol. 2007 Mar 21;13(11):1696-700. doi: 10.3748/wjg.v13.i11.1696.

Abstract

Aim: To evaluate computed tomography (CT) findings, useful to suggest the presence of refractory celiac disease (RCD) and enteropathy associated T cell lymphoma (EATL).

Methods: Coeliac disease (CD) patients were divided into two groups. Group I: uncomplicated CD (n = 14) and RCD type I (n = 10). Group II: RCD type II (n = 15) and EATL (n = 7).

Results: Both groups showed classic signs of CD on CT. Intussusception was seen in 1 patient in group I vs 5 in group II (P = 0.06). Lymphadenopathy was seen in 5 patients in group II vs no patients in group I (P = 0.01). Increased number of small mesenteric vessels was noted in 20 patients in group I vs 11 in group II (P = 0.02). Eleven patients (50%) in group II had a splenic volume < 122 cm3 vs 4 in group I (14%), 10 patients in group I had a splenic volume > 196 cm3 (66.7%) vs 5 in group II (33.3%) P = 0.028.

Conclusion: CT scan is a useful tool in discriminating between CD and (Pre) EATL. RCD II and EATL showed more bowel wall thickening, lymphadenopathy and intussusception, less increase in number of small mesenteric vessels and a smaller splenic volume compared with CD and RCD I.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Celiac Disease / complications
  • Celiac Disease / diagnostic imaging*
  • Celiac Disease / pathology
  • Diagnosis, Differential
  • Female
  • Humans
  • Intestines / diagnostic imaging
  • Intestines / pathology
  • Lymphoma, T-Cell / complications
  • Lymphoma, T-Cell / diagnostic imaging*
  • Lymphoma, T-Cell / pathology
  • Male
  • Mesentery / blood supply
  • Middle Aged
  • Organ Size
  • Radiography, Abdominal / methods
  • Spleen / pathology
  • Tomography, X-Ray Computed / methods*