Histiocytic lymphoma of the abdomen: radiographic spectrum

Abdominal manifestations of histiocytic lymphoma were reviewed in 112 patients who had at least a 2-year follow-up period or had died. In 70% abdominal histiocytic lymphoma was found and in 29% histiocytic lymphoma was initially limited to the abdomen. Localized abdominal histiocytic lymphoma presented as (1) intrinsic disease of the stomach, (2) pancreatic/peripancreatic masses, (3) high aortic lymphadenopathy, (4) mesenteric masses associated with small bowel infiltration, and (5) intrinsic ileocolic masses. When all patients with abdominal histiocytic lymphoma are considered, computed tomography was positive in 87%, lymphography in 86%, upper gastrointestinal barium examination in 50%, excretory urography in 38%, and barium enema in 25%. The extent of abdominal histiocytic lymphoma was more accurately assessed with computed tomography than any other radiologic examination including lymphography. Computed tomography seems to be the radiologic examination of choice in the staging of abdominal histiocytic lymphoma; the other examinations should be used when specific symptoms are present or when the computed tomographic findings are equivocal.