Cavitating mesenteric lymph node syndrome: a rare complication of celiac disease—case report and literature review

Background: Cavitating Mesenteric Lymph Node Syndrome (CMLNS) is an uncommon complication of celiac disease, characterized by cystic mesenteric lymph nodes and high morbidity. Case Presentation: A 46-year-old male with chronic diarrhea, vomiting, and weight loss had hypoalbuminemia and elevated anti-TTG IgA. Duodenal biopsy confirmed celiac disease (Marsh IIIb). CT showed pseudocystic mesenteric lymph nodes and splenic atrophy, initially suggesting malignancy. Laparoscopic excision revealed cavitated lymph nodes with liquefactive necrosis and an inflammatory rim, excluding lymphoma or infection. The patient received a gluten-free diet, nutritional support, and corticosteroids, achieving clinical improvement and stable imaging at six months. Conclusion: CMLNS should be considered in celiac patients with refractory symptoms and atypical imaging. Early recognition through clinical, radiological, and pathological assessment, combined with a gluten-free diet and supportive care, is crucial to improve outcomes.