Endoscopic and image features in primary gastro-intestinal lymphoma: a 7-year experience

Primary gastro-intestinal lymphoma (PGIL) has various presentations in the gastrointestinal tract. Between 1987 and 1993, we examined 90 cases, using radiography, sonography and/or endoscopy, in an attempt to characterize the lesions of PGIL.

Patients suffering from PGIL lesions were investigated with the combined modalities of radiology. Sonography and endoscopy. The data was reviewed retrospectively. All cases were proven by tissue histology obtained by biopsy or surgical resection.

We characterized seven growth patterns of PGIL: ulceration, infiltration, stricture, obstruction, erosion-like lesion, new growth (divided into 3 sub-groups: nodule, polypoid and mass) and perforation. Ulcerative lesion was found to be predominant in stomach (80.5%, P < 0.001) and duodenum (71.4%, P< 0.01) comparing with small (19.2%) and large (43.8%) bowel. The positive rate of gastric biopsy using endoscopy was 86% (31/36 biopsy cases). New growth pattern was the second main feature in PGIL, and one of the new growths, namely the mass, was predominant feature in terminal ileum (71.4%, P<0.001) and colon (62.5%, P < 0.001) when compared with stomach. Ulceration was a more frequent lesion in gastric and duodenal lymphoma. Cecal and terminal ileal lymphomas were mainly presented as new growth lesions, following the mass pattern.

Radiographic, sonographic, and endoscopic studies showed different patterns in PGIL. A combination of these modalities was recommended in the evaluation of various lesions of PGIL.