Learning objectives
Review the common locations and types of gastro-intestinal (GI) lymphomas.
Illustrate the spectrum of appearances of GI lymphoma using CT scan.
Background
Lymphomas are lymphoproliferative malignancies arising from clonal lymphocyte proliferation.
Extranodal lymphoma (dominant extranodal component) occurs in about 40% of cases and is more common with non-Hodgkin’s lymphoma.
SecondaryGI lymphoma is more common than primaryone which usually involves only one site.
GIlymphoma occurs in 10 to 30% of patients with extranodal lymphoma.
The stomach is most commonly involved followed by the small intestine,
pharynx,
large bowel and rarely,
esophagus.
The majority of non-Hodgkin’s lymphomas of theGI tract are of B-cell origin.
Mucosa associated lymphoid tissue (MALT)...
Findings and procedure details
GI lymphoma has a wide variety of imaging appearances and definitive diagnosis relies on histopathologic analysis.
However,
certain findings can strongly suggest the diagnosis.
The most commonly used imaging is computed tomography.
1/ Gastric lymphoma:
The stomach is the most frequent site ofGI lymphoma accounting for about 50% of cases.
MALT lymphoma is closely associated with chronic inflammation,
such as HP infection and can transform into intermediate or high-grade large cell lymphoma if not diagnosed or treated in time.
CT patterns include:
♦ The infiltrative...
Conclusion
Gastrointestinal lymphoma is an uncommon disease with a wide variety of imaging appearances.
Radiologists should consider the diagnosis in patients with or without a history of lymphoma in the presence of suggestive imaging findings and clinical features.
Although there is no specific appearances,
features such as a diffuse infiltration with preservation of fat planes and no obstruction,
bulky mass,
multiple site involvement,
and associated bulky lymphadenopathy are suggestive of lymphoma.
CT scan is the most used imaging modality providing overall assessment of the disease.
References
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The different faces of lymphoma.
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Non-Hodgkin’s Lymphoma of the Gastrointestinal Tract: Radiographic Findings.
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