Lymphocytic interstitial pneumonia and abdominal lymphoma complicating celiac sprue

We report the development of lymphocytic interstitial pneumonia followed later by abdominal lymphoma in a 62-year-old woman with celiac sprue. She presented with dyspnea, cough, weight loss, and bibasilar pulmonary infiltrates. Lung biopsy demonstrated lymphocytic interstitial pneumonia and corticosteroid therapy resulted in clinical and radiological improvement. She remained well for just over a year until abdominal pain developed and investigation revealed an abdominal lymphoma. Chemotherapy effectively controlled the lymphoma while the lymphocytic interstitial pneumonia was satisfactorily managed by corticosteroid therapy. Although lymphoma is a well-recognized complication of celiac sprue, it is not associated with lymphocytic interstitial pneumonia, despite a number of other reports describing the occurrence of pulmonary disease in this disorder.