Non-Hodgkin's lymphoma of the appendix: clinical and CT findings with pathologic correlation

The purpose of this report is to describe the clinical, CT, and pathologic features of non-Hodgkin's lymphoma of the vermiform appendix.

Non-Hodgkin's lymphoma of the appendix typically manifests with acute symptoms in patients who have no prior history of lymphoma. Most patients with the disease present clinically with signs and symptoms suggestive of acute appendicitis. On CT, lymphomatous infiltration of the appendix produces markedly diffuse mural soft-tissue thickening (range of diameters, 2.5-4.0 cm; mean diameter, 3.2 cm). The vermiform morphology of the appendix is usually maintained, and aneurysmal dilatation of the lumen is sometimes seen. Stranding of the periappendiceal fat seen on CT may represent superimposed inflammation or even direct lymphomatous extension. Coexisting abdominal lymphadenopathy is not seen in all patients. Although appendiceal lymphoma is rare, the characteristic CT appearance could lead to a preoperative diagnosis.