Non-Hodgkin lymphoma of the gastrointestinal tract

The gastrointestinal tract is the most commonly involved extranodal site of lymphoma. Primary gastrointestinal lymphoma must be recognized, characterized, and staged accurately, since, in some areas of the bowel, prognosis and therapy vary substantially when compared with those for other neoplasms, especially carcinoma. Radiologic studies, particularly barium studies of the bowel and computed tomography, may be crucial and only noninvasive modalities to use for the evaluation of gastrointestinal lymphoma. Symptoms are nonspecific and may be present for years before a diagnosis is established. Histologic appearance consists of a dense accumulation of lymphocytic tumor cells in a uniform pattern. Gastrointestinal lymphoma produces a spectrum of pathologic and radiologic appearances. Management of the condition may be accomplished with surgical resection, tumor debulking, or palliation. The advantages of postoperative radiation therapy and chemotherapy are not clear. Primary gastrointestinal lymphoma is encountered often enough to warrant familiarity with the clinical, radiologic, and therapeutic options.