ENTEROPATHY-ASSOCIATED T-CELL LYMPHOMA PRESENTING AS AN ISOLATED CNS LYMPHOMA 3 YEARS AFTER DIAGNOSIS OF CELIAC-DISEASE - T-CELL RECEPTOR POLYMERASE CHAIN-REACTION STUDIES FAILED TO SHOW THE ORIGINAL ENTEROPATHY TO BE A CLONAL DISORDER

A case of enteropathy associated T cell lymphoma is reported in a 45 y ear old woman, presenting with isolated disease in the CNS, three year s after diagnosis of coeliac disease. Initial staging showed no eviden ce of gastrointestinal tract lymphoma. A presumptive diagnosis of T ce ll primary cerebral lymphoma was made and the patient was treated with combination chemotherapy and craniospinal radiotherapy. The patient r elapsed, seven months after treatment, with small bowel lymphoma. The immunophenotype and T cell receptor polymerase chain reaction analysis confirmed the same tumour as in the CNS. Retrospective polymerase cha in reaction analysis of intraepithelial lymphocytes in the duodenal bi opsy sample, taken at the time of diagnosis of coeliac disease, failed to show evidence of a clonal T cell proliferation.