Radiologic features of multinodular lymphoma of the colon

The colon is frequently involved in patients with systemic malignant lymphoma and may be the site of initial clinical presentation. Multiple nodules are one of the manifestations of colonic lymphoma. In an effort to determine the most useful and characteristic features, the radiographic findings in 23 patients with multinodular colonic lymphoma were reviewed. The most characteristic radiographic features were identified: (1) variably sized, smooth, sessile nodules with an average diameter of 7 mm; (2) a cecal mass larger than 3 cm; (3) distortion of the haustra ; (4) incomplete evacuation of barium; and (5) involvement of the stomach, small bowel, or spleen. Less common were irregular, pedunculated, or filiform nodules and occasional umbilication . The differential diagnosis includes gastrointestinal polyposis, benign lymphoid hyperplasia, and inflammatory bowel disease. The radiologist may be the first to suggest the correct diagnosis when lymphoma patients present with multiple colonic nodules.