In lymphangiectasia, dilation and dysfunction of intestinal lacteals lead to what sequence?

• A. Mucosal ulceration
• B. Hyperplasia of villi
• C. Bile acid malabsorption
• D. Leakage of protein-rich lymph into gut lumen

Answer: (D)

Lymphangiectasia disrupts the lymphatic vessels in the intestinal villi, causing the lacteals to dilate and become leaky. The lymph carried by these vessels is protein-rich, so when the lacteals leak into the gut lumen, proteins such as albumin and immunoglobulins are lost into the intestinal contents. This protein-losing enteropathy explains the hallmark features like hypoalbuminemia and edema. The other options don’t fit because mucosal ulcers, villous hyperplasia, or bile acid malabsorption aren’t direct consequences of dilated, dysfunctional lacteals.