Lymphoid Hyperplasia - Ileum

40 y/o F
15-month history of wt loss, low-grade fever, fatigue, severe abdominal pain (always in the same spot [RUQ]).  Chronic constipation.  

Endoscopy of ileum (this week) showed scattered "lymphoid hyperplasia."  Currently awaiting pathology report.

Previous biopsy results:
"Increased intramucosal lymphocytes"
"Increase in intraepithelial lymphocytes"
"Crypt atrophy"
"Lamina Propria fibrosis"
"Prominent apoptotic debris at the foci of cryptitis"

CT scan showed slightly enlarged spleen
Transient intussusception at ileocecal valve
Tests for celiac were negative
Vitamin deficiencies: A, B, D3, K

As mentioned above, the report from the endoscopy this week reflects "lymphoid hyperplasia."  The pathology report won't be back until next week.

Quesion: My understanding is that this type of tissue is a possible indicator of intestinal lymphoma.  What are your thoughts?  
By the way, I had follicular thyroid cancer earlier this year (and autoimmune thyroiditis [Hashimoto's]) and had a total thyroidectomy.)

Thanks.

[Kevin Pho, MD]

Lymphoid hyperplasia has been implicated as a possible risk factor for lymphoma.  It is often associated with immunodeficiency - such as common variable immunodeficiency or selective IgA deficiency.

There are no conclusive studies, but the smaller ones do show an association.  

I would discuss this question with your gastroenterologist, and possibly start some kind of screening program to exclude the development of lymphoma.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_