Primary esophageal lymphoma in immunocompetent patients: Two case reports and literature review

Abstract

Primary lymphoma that involves the esophagus is very rare, with fewer than 30 cases reported in the English-language literature. Non-Hodgkin lymphoma accounts for most of the cases. Esophageal lymphomas have varied radiological appearances, which poses diagnostic difficulty. We report two cases of histopathologically confirmed primary diffuse large B-cell esophageal lymphoma and describe their radiological features, and briefly review the literature.

Keywords: Computed tomography; Esophageal neoplasms; Esophagography; Non-Hodgkin lymphoma; Primary lymphoma.

Figure 1

Barium esophagogram shows irregular outline and multiple filling defects (arrow), with short segment narrowing of the distal segment of the esophagus involving right side posterolaterally.

Figure 2

Computed tomography scan of the thorax. A: Plain computed tomography (CT) showing asymmetrical thickening of the esophageal wall (white arrow) with maintenance of the surrounding fat plane. No mediastinal lymphadenopathy is seen; B: Contrast-enhanced CT shows moderate enhancement of the lesion (white arrow); C: Coronal multiplanar reconstructed (MPR) CT image demonstrating the thickened esophagus (white arrow); D: Sagittal MPR CT image showing extension of the lesion (between two arrows).

Figure 3

Photomicrograph of the biopsy specimen demonstrating large transformed lymphoid cells with vesicular nuclei and prominent nucleoli, which was suggestive of diffuse large B-cell lymphoma (hematoxylin and eosin, × 200).

Figure 4

Esophagogastroduodenoscopy (A and B) showing multiple solid, firm nodular lesions in the lower esophagus. Overlying mucosa appearing relatively normal (black arrows).