Gastrointestinal lymphoproliferative lesions: a practical diagnostic approach

Area of Science:

• Gastroenterology
• Hematopathology
• Oncology

Background:

• The gastrointestinal tract is a common site for lymphoproliferative disorders, ranging from benign hyperplasia to lymphoma.
• Accurate diagnosis of these conditions is complex, necessitating a multidisciplinary approach.

Purpose of the Study:

• To review key histological features of common gastrointestinal non-Hodgkin lymphomas (NHLs).
• To outline a diagnostic workup strategy for GI lymphoproliferative lesions.
• To discuss differential diagnoses and potential diagnostic challenges.

Main Methods:

• Review of histological features, immunohistochemistry, and molecular data for GI lymphoproliferative lesions.
• Categorization of lymphomas into small to medium B-cell, medium to large B-cell, and T-cell NHLs.
• Inclusion of mimickers of Hodgkin lymphoma and their diagnostic criteria.

Main Results:

• Detailed description of histological characteristics for various GI NHL subtypes.
• Emphasis on a stepwise diagnostic approach, starting with benign versus neoplastic assessment.
• Identification of common pitfalls and differential diagnoses for each lesion group.

Conclusions:

• An integrated diagnostic strategy combining clinical, morphological, immunohistochemical, and molecular data is crucial for GI lymphoproliferative lesions.
• Histological evaluation is the primary step in differentiating benign from neoplastic lymphoid infiltrates.
• Understanding distinct NHL categories and their mimics aids in accurate diagnosis and patient management.