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Cavitation of mesenteric lymph nodes: a rare complication of coeliac disease, associated with a poor outcome
Author(s) -
HOWAT A.J.,
McPHIE J.L.,
SMITH D.A.,
AQEL N.M.,
TAYLOR A.K.M.,
CAIRNS S.A.,
THOMAS W.E.G.,
UNDERWOOD J.C.E.
Publication year - 1995
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/j.1365-2559.1995.tb01525.x
Subject(s) - medicine , mesenteric lymph nodes , villous atrophy , lymph , autopsy , atrophy , complication , pathology , abdomen , pneumonia , coeliac disease , lymphatic system , gastroenterology , surgery , disease , spleen
Five cases are presented, all of which showed peculiar cavitation of mesenteric lymph nodes. Clinically, three presented with abdominal symptoms, a mass or obstruction, warranting laparotomy. Two patients showed cavitating mesenteric lymph nodes at autopsy. Lymph nodes were enlarged with central, partly cystic degeneration; milky fluid exuded from the cut surface. In each case, investigation showed intestinal villous atrophy and splenic atrophy; coeliac disease was confirmed by response to gluten withdrawal. Three patients died, two from cachexia and the other from pneumonia; the other two are alive and well one year and six years after presentation. Review of the literature shows 12 previously reported cases, with a mortality of about 50%. The diagnosis is made by the histopathologist, alerting appropriate treatment. The pathogenesis is unknown.