Immunoproliferative small-intestinal disease with lymphoma--diagnostic difficulties and pitfalls. Case reports

Immunoproliferative small-intestinal disease and related diffuse intestinal lymphoma is a debilitating illness prevalent in South Africa. Case reports are presented to illustrate that the early course may be deceptively prolonged and 'benign'; diarrhoea is not invariable, and an initial clinical response to antibiotics may occur. The combination of villous atrophy and a predominantly plasma cell infiltration of the lamina propria in jejunal biopsy specimens may indicate lymphoma in adjacent bowel or regional lymph nodes.