Sonographic staging of gastrointestinal lymphoma

Abstract

The ultrasound findings of 580 patients with malignant lymphoma were reviewed. Conventional sonography was able to show different extents of distinctly hypoechoic bowel wall thickening due to lymphatic infiltration in 53 patients (9%) who had gastric (n = 37), enteric (n = 5), colonic (n = 7) or multiple (n = 4) involvement. In all patients, the diagnoses were confirmed by histological examination. Non-Hodgkin lymphomas (NHL) were found in 49 patients, while 4 had Hodgkin's disease. As part of staging procedures, sonography enabled the identification of regional and non-regional abdominal lymph node enlargement in 32 out of 53 patients, and therefore subdivides different stages of gastrointestinal lymphoma. Low grade malignant NHL of the gastrointestinal tract (n = 21) tends to represent generalized disease with secondary intestinal involvement (18 out of 21), those of high grade malignancy (n = 28) were present with both primary (n = 15) and secondary (n = 13) lymphoma of the gastrointestinal tract. The results of this study demonstrate the value of conventional ultrasound for identification of both gastrointestinal involvement as well as abdominal lymph node enlargement in lymphoma staging.