Peripheral T-cell lymphoma following diffuse large B-cell lymphoma associated with celiac disease

Celiac disease is a risk factor for lymphoma. Previously, we reported a case of diffuse large B-cell lymphoma (DLBCL) associated with celiac disease in a Japanese patient. Without any signs of DLBCL recurrence, he suddenly developed gastrointestinal symptoms and subcutaneous masses after resuming a gluten-containing diet. Peripheral T-cell lymphoma (PTCL) was diagnosed. Although a complete response was seen for 8 months, he was later admitted again with pleural and pericardial effusion due to PTCL. Expression of cytotoxic molecules, CCR4 and CXCR4 were all confirmed in PTCL cells, and the patient died soon afterwards. Clinically speaking, even though no gastrointestinal symptoms were seen, a gluten-free diet should have been strongly recommended for this patient.