Lymphadenopathy in celiac disease: computed tomographic observations

Area of Science:

• Gastroenterology
• Oncology
• Radiology

Background:

• Lymphadenopathy in celiac disease (CD) is often concerning due to its association with intestinal lymphoma.
• Computed tomography (CT) is frequently used to evaluate abdominal complaints in CD patients.

Purpose of the Study:

• To describe cases of significant mesenteric and paraaortic adenopathy in patients with celiac disease.
• To investigate the underlying causes and clinical course of lymphadenopathy in these patients.

Main Methods:

• Case series of four patients with celiac disease and CT-demonstrated lymphadenopathy.
• Clinical follow-up, exploratory laparotomy, and repeat CT scans were utilized.

Main Results:

• No evidence of lymphoma was found in any of the four patients.
• Two patients with relapsed CD showed reactive hyperplasia in enlarged glands, with regression after treatment.
• Two other patients experienced regression of adenopathy following a gluten-free diet, with one case resolving after a year.

Conclusions:

• Mesenteric and paraaortic adenopathy in celiac disease patients can represent reactive hyperplasia, not necessarily lymphoma.
• A gluten-free diet and appropriate management can lead to the resolution of lymphadenopathy in celiac disease.
• These findings suggest a need for careful evaluation to avoid misdiagnosis of lymphoma in CD patients with adenopathy.