[Radiographic diagnosis of gastrointestinal lymphoma]

The gastrointestinal tract is very infrequently involved by malignant lymphoma. Primary lymphoma accounts for 1-4% of all gastrointestinal tumors. The stomach is the most common site of primary non-Hodgkin lymphoma. Esophagus is least likely site of lymphoma of the gastrointestinal tract. Hodgkin disease is almost exclusively a nodal disease, and the involvement of gastrointestinal tract usually is the result of disseminated disease that began in nodal sites. Gastrointestinal lymphomas have a wide array of appearances, which can be explained by the nature of lymphocytes and the variety of ways in which their malignant counterparts can develop and spread. The radiographic appearance of gastrointestinal lymphoma varies. Frequently, an appearance is indistinguishable from a primary adenocarcinoma, from other primary mural masses, such as smooth muscle tumors. The radiograph double-contrast barium study remains the screening procedure. Computed tomography plays a pivotal role in management of the process of staging in patient with lymphoma. CT is comparable in its ability to detect retroperitoneal and pelvic lymph nodes. Also 99mTc-MIBI scintigraphy and 99mTc-MIBI uptake within the lymphomatous tumors are helpful. During 1991-2000, 63 patients with suspected lymphoma of gastrointestinal tract were examined in Clinic of Radiology of Kaunas University Hospital. Contrast-enhanced CT had shown 79.3 percent involvement in mesenterial lymph nodes, X-ray double-barium study--14.2 percent in stomach, 3 percent in small intestine, 1.5 percent in colon.