Clinical characteristics of a group of adults with nodular lymphoid hyperplasia: a single center experience.

Aim: To describe the clinical and histological characteristics of a group of adults with small-bowel nodular lymphoid hyperplasia (NLH).

Methods: Patients were searched for five years in pathology records of our institution. The biopsy material was reassessed using strict histopathological criteria. Clinical data were obtained from medical records.

Results: Small-bowel NLH was diagnosed in 18 cases. The female: male ratio was 2:1. The most frequent symptoms were diarrhea (72%), involuntary weight loss (72%) and abdominal pain (61%). Nine patients (50%) had immunodeficiency. Small-bowel bacterial overgrowth was found in three (17%) cases. At small-bowel NLH diagnosis, three (17%) had associated lymphoma: two intestinal and one extra-intestinal lymphomas. In two patients with villous atrophy and anti-endomysial antibodies the diagnosis of celiac disease was established. Giardia lamblia infection was found in only one patient with hypogammaglobulinemia (Herman's syndrome).

Conclusions: NLH is uncommon in adult patients. Associated diseases are immunodeficiency and lymphoid tissue malignancies.