The Mesenteric Lymph Node Cavitation Syndrome may occur in patients with celiac or celiac-like disorders. It is associated with a number of complications that may convey a poor prognosis.
Features of mesenteric lymph node cavitation syndrome:
(1) presence of either celiac disease or sprue-like disorder unresponsive to gluten-free diet
(2) central necrosis of mesenteric lymph nodes (seen on biopsy or imaging studies)
(3) variable hyposplenism and/or splenic atrophy
(4) exclusion of other diagnoses (Yersinia, Whipple's disease, mycobacteria, SLE or vasculitis)
Complications:
(1) sepsis
(2) T-cell lymphoma (enteropathy-associated T-cell lymphoma) or other malignancy
(3) mediastinal lymph node cavitation
where:
• T-cell lymphoma may be associated with a vasculopathy which can affect the central nervous system. Enteropathy-associated T-cell lymphoma may present as a sprue-like disorder unresponsive to gluten-free diet. One interpretation is that the T-cell lymphoma is a complication of the enteropathy. Another is that an enteropathy may be a manifestation that precedes full expression of the lymphoma.
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