[Mediterranean lymphoma mimicking Crohn's disease]. / Lymphome méditerranéen simulant une maladie de Crohn.

We report an uncommon localization of mediterranean lymphoma of the terminal ileum in a 28 year-old male patient. Ultrasound and Computed Tomography showed moderate regular and symmetrical intestinal wall thickening simulating Crohn's disease. We highlight the role of computed tomography in the diagnosis, staging and detection of complications.

Cells expressing intracytoplasmic immunoglobulins in secreting and hyposecreting cases of alpha chain disease.

Alpha chain disease proteins (ACDP) originated probably from secreting plasma-cells predominantly present in diffuse and massive enteromesenteric lymphoid infiltration. Very decreased levels of abnormal alpha chain molecules were detected in sera of patients with immunoblastic lymphoma occurring in the late course of the disease. A direct correlation might exist between the proportion of cells bearing intracytoplasmic IgA determinants and the serum amounts of alpha chain disease protein. Relevant evidence raised from study of proliferating lymphoid cells using the unlabeled peroxidase anti-peroxidase method of immunocytochemistry. The percentage of cells expressing intracytoplasmic alpha chains was found to be greater readily secreting case than in hyposecreting case of alpha chain disease. Furthermore, the cells from secreting situation exhibited much more pronounced specific staining, indicative of probably more active synthesis state. Taken together with histological data, these results suggested a possible late evolutionary pathway without detectable intracytoplasmic and serum alpha chain disease protein. They might also support the hypothesis that alpha chain disease and mediterranean lymphoma were different evolutionary phases of the same entity.

Results of laparotomy in immunoproliferative small intestinal disease.

Immunoproliferative small intestinal diseases (IPSID), previously known as Mediterranean Lymphomas, constitute more than 60% of the non-Burkitt's small intestinal lymphomas in Tunisia. A multidisciplinary study of IPSID was undertaken by the Tunisian/French Lymphoma Study Group in 1980 to reach a better understanding of the two subgroups of the disease: secreting IPSID (essentially alpha-chain disease [ACD]); and nonsecreting IPSID (NS-IPSID) (extensive small intestinal lymphomas without gammopathy). The results of initial exploratory laparotomy performed in 38 cases of IPSID (17 ACD and 21 NS-IPSID) are described here, and show notable similarities between the two groups: the extensive pattern of the abnormal cell infiltrate along the major part of the small intestine; frequent and extensive involvement of the mesenteric lymph nodes; the existence of several degrees of severity in small intestinal mesenteric lymph nodes; and other intraabdominal organ involvement. Certain differences also were observed: the relatively high degree of tropism of the NS-IPSID towards the gastric mucosa which was absent in the ACD of this series; and the more frequent involvement of the entire length of the small bowel in ACD. In spite of these discrete differences, the IPSID form a homogeneous group which is definitely distinguishable from the segmentary small intestinal lymphomas known as Western-type, and which account for approximately one third of our non-Burkitt's small bowel lymphomas.