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

doi:10.3748/wjg.v13.i11.1696

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World Journal of Gastroenterology

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1007-9327

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Clinical Research

World J Gastroenterol. Mar 21, 2007; 13(11): 1696-1700
Published online Mar 21, 2007. doi: 10.3748/wjg.v13.i11.1696

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

Jan Hein van Waesberghe, Chris Mulder, Radu Manoliu, Maarten Jacobs, Matthijs Kater, Abdul-Baqi Al-Toma, Muhammed Hadithi, Maarten Mallant

Maarten Mallant, Matthijs Kater, Radu Manoliu, Jan Hein van Waesberghe, Departement of Radiology, VU University Medical Center, Amsterdam, The Netherlands

Muhammed Hadithi, Abdul-Baqi Al-Toma, Maarten Jacobs, Chris Mulder, Departement of Gastroenterology, Small Bowel Unit, VU University Medical Center, Amsterdam, The Netherlands

Author contributions: All authors contributed equally to the work.

Correspondence to: JHTM van Waesberghe, MD, PhD, VU University Medical Center, Department of Radiology, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. jhtm.vanwaesberghe@vumc.nl

Telephone: +31-20-4442863 Fax: +31-20-4442831

Received: January 8, 2007
Revised: January 28, 2006
Accepted: March 12, 2007
Published online: March 21, 2007

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. GroupI: uncomplicated CD (n = 14) and RCD typeI(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 groupIvs 5 in group II (P = 0.06). Lymphadenopathy was seen in 5 patients in group II vs no patients in groupI(P = 0.01). Increased number of small mesenteric vessels was noted in 20 patients in groupIvs 11 in group II (P = 0.02). Eleven patients (50%) in group II had a splenic volume < 122 cm³vs 4 in groupI(14%), 10 patients in groupI 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 RCDI.

Keywords: Coeliac disease; Refractory coeliac disease; Enteropathy associated T-cell lymphoma; Computed tomography; Bowel wall thickening; Lymphadenopathy; Intussusception; Splenic volume

Mallant M, Hadithi M, Al-Toma AB, Kater M, Jacobs M, Manoliu R, Mulder C, van Waesberghe JH. Abdominal computed tomography in refractory coeliac disease and enteropathy associated T-cell lymphoma. World J Gastroenterol 2007; 13(11): 1696-1700 [PMID: 17461472 DOI: 10.3748/wjg.v13.i11.1696]

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