Primary Gastrointestinal Lymphoma: Spectrum of Imaging Findings with Pathologic Correlation

Abstract

Gastrointestinal lymphoma is an uncommon disease but is the most frequently occurring extranodal lymphoma and is almost exclusively of non-Hodgkin type. Primary gastrointestinal lymphoma most commonly involves the stomach but can involve any part of the gastrointestinal tract from the esophagus to the rectum. Risk factors for the development of gastrointestinal lymphoma include Helicobacter pylori infection, immunosuppression after solid organ transplantation, celiac disease, inflammatory bowel disease, and human immunodeficiency virus infection. Although gastrointestinal lymphoma has a wide variety of imaging appearances and definitive diagnosis relies on histopathologic analysis, certain findings (eg, a bulky mass or diffuse infiltration with preservation of fat planes and no obstruction, multiple site involvement, associated bulky lymphadenopathy) can strongly suggest the diagnosis. Imaging also plays an important role in the detection of complications such as perforation, obstruction, and fistulization. The most commonly used imaging modalities are barium examination and computed tomography (CT). These modalities are complementary, although CT provides a better overall assessment of the disease stage.

Gastric lymphoma

“…Transpyloric spread and extension of lymphadenopathy below the renal hilum and the presence of bulky lymph nodes are more suggestive of lymphoma than carcinoma. 15 The patterns of gastric involvement observed can be segmental or diffuse infiltration, or localized polypoid. Tumor infiltration is usually homogeneous although areas of low attenuation may be present in larger tumors.…”

Extremely rare case of primary esophageal mucous associated lymphoid tissue lymphoma

“…Gastrointestinal (GI) lymphoma is an uncommon disease but is the most frequently occurring extra nodal lymphoma and is almost exclusively Non-Hodgkin's type [1] . Esophageal lymphomas occur most often secondary to cervical and mediastinal lymph node invasion or contiguous spread from gastric lymphoma [1] .…”

“…Esophageal lymphomas occur most often secondary to cervical and mediastinal lymph node invasion or contiguous spread from gastric lymphoma [1] . Primary esophageal lymphomas is a very rare condition accounting for less than one percent of GI lymphomas, with B cell lymphomas being the most common histological subtype [2] .…”

Gastrointestinal lymphoma: spectrum of fluoroscopic and CT findings

“…Lesions can assume nodular, polypoid, cavitary, ulcerative or diffuse infiltrating (submucosal) forms (1,2). High-grade lesions cause focal, large masses with a diameter of ≥5 cm (22,23).…”

“…2 and 3) (2). In the differential diagnosis, it is very important that the gastric luminal diameter is preserved despite diffuse submucosal infiltration (1,2). However, some HLs and NHLs cause a linitis plastica appearance that mimics primary scirrhosing carcinoma (25,26).…”