Traditionally, lymphomas have been divided into Hodgkin or non-Hodgkin lymphoma (NHL), depending on whether Reed-Sternberg cells are identified or not, respectively.
Fig. 1: WHO classification of lymphoma 2008
References: Evens AM, Winter JN, Gordon LI et al. Non-Hodgkin Lymphoma. 2011. Cancer Management, 13th edition.
The stomach is the commonest site for lymphoma within the gastrointestinal tract, followed by the small intestine, pharynx, large intestine, and finally oesophagus.[3]
Fig. 2: Diffuse large B cell lymphoma (DLBCL): large tumour cells with vesicular chromatin, prominent nucleoli and moderate to abundant amount of cytoplasm (H&E, 400×).[7]
References: Bautista-Quach MA, Ake CD, Chen M, Wang J. Gastrointestinal lymphomas: Morphology, immunophenotype and molecular features. J Gastrointest Oncol 2012;3(3):209-225.
Fig. 3: Burkitt lymphoma: characteristic 『starry sky』 appearance and frequent mitotic figures (H&E, 400×).[7]
References: Bautista-Quach MA, Ake CD, Chen M, Wang J. Gastrointestinal lymphomas: Morphology, immunophenotype and molecular features. J Gastrointest Oncol 2012;3(3):209-225.
Fig. 4: Enteropathy associated T-cell lymphoma (EATCL): monomorphous, neoplastic lymphoid infiltrate (H&E, 500×). The inset image (upper left, H&E, 20×) demonstrates involvement of surface epithelium.[7]
References: Bautista-Quach MA, Ake CD, Chen M, Wang J. Gastrointestinal lymphomas: Morphology, immunophenotype and molecular features. J Gastrointest Oncol 2012;3(3):209-225.
Fig. 5: Ann Arbor staging system
References: Boot, H. Best Practice & Research Clinical Gastroenterology. 2010. 24: 3–12
Fig. 6: Lugano staging system
References: Boot, H. Best Practice & Research Clinical Gastroenterology. 2010. 24: 3–12
Fig. 7: Paris staging system
References: Boot, H. Best Practice & Research Clinical Gastroenterology. 2010. 24: 3–12
Findings and procedure details
Fig. 8: Sagittal CT slice illustrating mural thickening in a segment of ileum.
References: Radiology Department, Lymington New Forest Hospital, Lymington
Fig. 9: Oblique coronal CT slice illustrating mural thickening in a segment of ileum.
References: Radiology Department, Lymington New Forest Hospital, Lymington
Fig. 10: Cine loop of coronal CT slices illustrating mural thickening in a segment of ileum.
References: Radiology Department, Lymington New Forest Hospital, Lymington
Fig. 11: Coronal CT slice illustrating mural thickening with luminal narrowing and shouldering in a segment of duodenum
References: Radiology Department, Lymington New Forest Hospital, Lymington
Fig. 12: Axial CT slice illustrating mural thickening in a segment of duodenum
References: Radiology Department, Lymington New Forest Hospital, Lymington
Fig. 13: Axial CT slice illustrating mural thickening and luminal narrowing in a segment of duodenum
References: Radiology Department, Lymington New Forest Hospital, Lymington
Fig. 14: Ultrasound image of the spleen showing splenomegaly with multiple hypoechoic regions.
References: Radiology Department, Lymington New Forest Hospital, Lymington
Fig. 15: Sagittal CT slice illustrating splenomegaly with multiple low attenuating regions, and a segment of small bowel with mural thickening.
References: Radiology Department, Lymington New Forest Hospital, Lymington
Fig. 16: Axial CT slice illustrating a segment of small bowel with mural thickening, and local lymph node enlargement.
References: Radiology Department, Lymington New Forest Hospital, Lymington
Fig. 17: Sagittal CT slice using maximum intensity projection (MIP) to illustrate a mesenteric mass abutting the small bowel, and encasing the superior mesenteric artery.
References: Radiology Department, Lymington New Forest Hospital, Lymington
Fig. 18: Cine loop of coronal CT slices illustrating a mesenteric mass abutting the small bowel, and encasing the superior mesenteric artery.
References: Radiology Department, Lymington New Forest Hospital, Lymington
Fig. 19: Coronal CT slice illustrating diffuse polypoid mural change.
References: Radiology Department, Lymington New Forest Hospital, Lymington
Fig. 20: Axial CT slice illustrating diffuse polypoid mural change.
References: Radiology Department, Lymington New Forest Hospital, Lymington
Fig. 21: Sagittal CT slice illustrating diffuse polypoid mural change.
References: Radiology Department, Lymington New Forest Hospital, Lymington
Fig. 22: Cine loop of axial PET-CT slices illustrating avid FDG uptake in the affected small bowel segment, as well as the spleen and stomach.
References: University Hospital Southampton - Southampton/UK
Fig. 23: Cine loop of axial PET-CT slices post-chemotherapy, illustrating normal uptake in the previously affected areas.
References: University Hospital Southampton - Southampton/UK
Fig. 24: Axial CT slice illustrating an intraluminal polypoid mass in the caecum.
References: Radiology Department, St Mary's Hospital, Newport, Isle of Wight
Fig. 25: Virtual 3D surface reconstruction from CT colonography illustrating a polypoidal intraluminal mass.
References: Radiology Department, St Mary's Hospital, Newport, Isle of Wight
Fig. 26: Cine loop of coronal CT images illustrating a polypoidal intraluminal mass in the caecum.
References: Radiology Department, St Mary's Hospital, Newport, Isle of Wight
FROM：http://dx.doi.org/10.1594/ecr2014/C-1431
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