Conspicuous enterocytic binding pattern for peanut lectin and malignant histiocytosis of the intestine

We present a case of a 33 year old male with a history of early childhood diarrhoea and more recently diagnosed gluten sensitive enteropathy, who died with active disease, ulcerative proctosigmoiditis and desquamative erythrodermia associated with toxin induced shock. Autopsy revealed a tumour restricted to lymph nodes of the mesentery and the retroperitoneum. This is considered to be malignant histiocytosis of the intestine (MIH). Immunohistological examination of the diagnostic jejunal biopsy showed a pathological binding pattern for peanut lectin (PNL) within the enterocytes. This may be an expression of disturbed production or secretion of a product rich in non-reducing terminal D-galactosyl residues.