CAVITATION OF MESENTERIC LYMPH-NODES - A RARE COMPLICATION OF CELIAC-DISEASE, ASSOCIATED WITH A POOR OUTCOME

Five cases are presented, all of which showed peculiar cavitation of m esenteric lymph nodes. Clinically, three presented with abdominal symp toms, a mass or obstruction, warranting laparotomy. Two patients showe d cavitating mesenteric lymph nodes at autopsy. Lymph nodes were enlar ged 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 respons e to gluten withdrawal. Three patients died, two from cachexia and the other from pneumonia; the other two are alive and well one year and s ix years after presentation. Review of the literature shows 12 previou sly reported cases, with a mortality of about 50%. The diagnosis is ma de by the histopathologist, alerting appropriate treatment. The pathog enesis is unknown.