Case report

Journal of Gastroenterology

, Volume 39, Issue 11, pp 1110-1113

First online:

Obstructive jaundice caused by enteropathy-associated T-cell lymphoma in a patient with celiac sprue

  • Martin BuessAffiliated withMedizinische Universitätsklinik Kantonsspital Bruderholz
  • , Michael SteuerwaldAffiliated withMedizinische Universitätsklinik Kantonsspital Bruderholz
  • , Werner WegmannAffiliated withKantonales Institut für Pathologie Liestal
  • , Madeleine RothenAffiliated withMedizinische Universitätsklinik Kantonsspital Bruderholz

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Patients with celiac sprue carry a considerable risk of gastrointestinal malignancies; in particular, non-Hodgkin’s lymphoma. These malignancies represent the most serious complications of celiac disease. Commonly, patients present with deteriorating symptoms of the underlying disease, which makes an early diagnosis difficult. We report a patient with a 13-year history of celiac sprue presenting with painless jaundice and a Courvoisier gallbladder. Abdominal computed tomography (CT) scan showed thickening of the duodenal wall, suggesting a neoplastic infiltration of the papilla of Vater, causing biliary obstruction. Biopsies taken on endoscopy revealed enteropathy-associated T-cell lymphoma of the duodenum. Biliary obstruction is a rare clinical finding in enteropathy-associated T-cell lymphoma. To our knowledge, this is the first reported case of this unusual manifestation in celiac disease.

Key words

celiac disease T-cell non-Hodgkin’s lymphoma Courvoisier gallbladder cholestasis