Endoscopic features of primary upper gastrointestinal lymphoma

Primary upper gastrointestinal lymphoma (PUGIL) is relatively common in the Middle East, and upper gastrointestinal (UGI) endoscopy is very useful for its diagnosis. Analysis of 33 patients with PUGIL revealed that ulceration, mainly superficial and/or multicentric, in 24 (73%) patients was the most frequent endoscopic feature. A granulonodular pattern was characteristic of duodenal involvement, but in contrast, infiltrative and polypoid patterns were more often seen in gastric lymphoma. Isolated involvement of the fundus was not seen in these patients. With a high index of suspicion and careful attention to mucosal details, the diagnosis of PUGIL may be made early by multiple biopsies during UGI endoscopy.