Gastrointestinal lymphoma: sonographic findings in 54 patients

Between 1980 and 1990, 580 patients with known malignant lymphoma were referred for sonography for evaluation of abdominal masses as a part of the initial staging of the disease. In 54 patients, sonography showed different degrees of hypoechoic bowel wall thickening; gastrointestinal lymphoma was confirmed by histologic examination in all of these patients (non-Hodgkin lymphoma in 50, Hodgkin disease in four). Nineteen of the 54 patients had primary gastrointestinal lymphoma; the other 35 had widespread tumor with secondary gastrointestinal involvement. The portions of gastrointestinal tract involved included the stomach (38), small intestine (five), colon (seven), and multiple sites (four). Several sonographic patterns were found: 39 patients had circumferential involvement of the bowel wall, four had bulky tumors, and two had nodular extraluminal spread. Eight patients had segmental infiltration, and one had mucosal involvement. The results of this study indicate that sonography is of value for examining patients with gastrointestinal lymphoma and that several patterns of involvement can be detected.