EXSUDATIVE ENTEROPATHY REVEALING DIFFUSE DIGESTIVE-TRACT B-CELL LYMPHOMA

BACKGROUND: Early manifestations of primary lymphomas of the digestive tract generally include general signs and abdominal pain. Diarrhea is uncommon and may result from several mechanisms. We report a case ol primary lymphoma of the digestive tract in a patient presenting exudat ive enteropathy. CASE REPORT: A 68-year-old woman was hospitalized for profuse diarrhea of 15 days duration. Laboratory tests showed major h ypoalbuminemia. Malabsorption could not be evidenced and no infectious foyer was found. Biopsies at different levels of the digestive tract showed mucosal invasion by MALT type B-cell lymphoma. The clinical cou rse was initially favorable after chemotherapy, DISCUSSION: Classifica tion of digestive tract lymphomas differentiates MALT type B-cell lymp homa (the most frequently encountered type in western countries), Medi terranean lymphomas, and T-cell lymphomas generally complicating coeli ac disease. MALT type lymphomas may occur in association with Helicoba cter pylori infection, usually in a gastric localization. Multiple loc alizations are uncommon and diffuse involvement of the digestive tract as in our observation appears exceptional. This extension would expla in the exsudative enteropathy which regressed with chemotherapy. (C) 1 998, Masson, Paris.