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Malignant diseases

Immunoproliferative small intestinal disease (IPSID).
A 28-year-old housewife presented with a 2-year history of voluminous diarrhea, 12 kg weight loss and pallor. She was found to have a hemoglobin of 8.5g/dL, MCV 65fL, and fecal fat12 g/24-hour. Duodenoscopy revealed a nodular mucosa; the mucosal biopsy was reported as malignant IPSID. Alpha heavy chain protein was positive in her serum.

She was treated with oral metronidazole and tetracycline followed by a 6-month course of CHOPP chemotherapy with good response.The radiographs show the characteristic barium bowel follow-through findings, with thickened small-bowel mucosal folds.

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