Wajeeha Khalid, Jamaluddin.
Coeliac Disease Complicating to B Cell Lymphoma and Enterocolic Fistula.
Ann Abbasi Shaheed Hosp Karachi Med Dent Coll Jan ;24(1):51-5.

We describe the case of 66 year old male, known case of COPD and type II diabetes mellitus, with a diagnosis of coeliac disease confirmed by the elevated titers of antigliadin and antiendomysium IgG antibodies together with partial villous atrophy in jejunal histology, complicating to diffuse large B cell lymphoma presented as enterocolic fistula. Laparotomy was performed which included gastrojejunostomy to bypass the fistula, ileo-ileal anastomosis to prevent obstruction, and end-transverse colostomy. Histology was taken from fistulous tract following laparotomy suspected high-grade non-Hodgkin's lymphoma. Further supplementary reports showed immunoperoxidase studies that the tumor cells are strongly positive for LCA and negative for CD30 and S100. These findings are suggestive of high grade non Hodgkins lymphoma which is confirmed by immunohistochemistry results. The biopsy showed high proliferation and soft tissue infiltration by diffuse large B-cell lymphoma which shows extensive apoptosis secondary to a complication of coeliac disease presenting as enterocoloc fistula.

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