Clinical Research
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
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
Maarten Mallant, Muhammed Hadithi, Abdul-Baqi Al-Toma, Matthijs Kater, Maarten Jacobs, Radu Manoliu, Chris Mulder, Jan Hein van Waesberghe
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