Radiographic and computed tomographic findings of gastric mucosa-associated lymphoid tissue lymphomas

The purpose of this retrospective study was to evaluate the detection of gastric mucosa-associated lymphoid tissue (MALT) lymphoma lesions by upper gastrointestinal (UGI) radiography and computed tomography (CT). Fifteen patients with endoscopic biopsy-proven MALT lymphoma were included. Fourteen of these patients underwent double-contrast UGI radiography and 14 were examined with CT of the upper abdomen; 13 underwent both procedures. UGI radiography identified 88% (30/34) of lesions detected by endoscopy, including 12 of 13 enlarged rugal folds and 15 of the 17 multinodular lesions, but failed to identify two of the three ulcerative lesions. UGI radiography identified the only submucosal lesion demonstrated by endoscopy, as well as one at the gastric antrum that had been missed by endoscopy. CT demonstrated nine of 30 endoscopically proven MALT lymphoma lesions, three with focal thickening of the gastric wall and six with a lobulated inner gastric wall. CT failed to demonstrate two fundal and 19 antral or gastric body lesions. Our findings suggest that the predominant UGI features of gastric MALT lymphoma are enlarged folds and multinodular lesions. Although UGI radiography does not reveal all MALT lymphoma lesions, it may find lesions that are not detected by endoscopy. Mucosal lesions of gastric MALT lymphoma are usually not detected by CT.