Ultrasound features of primary gastrointestinal lymphoma

Background: Ultrasound offers one of the best initial diagnostic procedures for evaluating patients suffering from lymphoma. However, as some infiltrative bowel disease is not easily differentiated from primary gastrointestinal lymphoma (PGIL), this study was designed to clarify the ultrasound features of PGIL. Materials and Methods: We retrospectively reviewed 90 digestive tract lesions in 79 consecutive patients with histologically proven PGIL. Sixty-three lesions were examined with ultrasound: 32 in the stomach, 11 in the large bowel (including six in the cecum, two in the A-colon, one in the whole colon, one in the sigmoid and one in the rectum), nine in the ileum, seven in the jejunum and four in the duodenum. Ultrasound examinations were undertaken using Aloka SSD-280 real-time scanners with 3.5-MHz linear, 5-MHz curved-array and transanal transducers. Results: Sonography showed the pattern of wall thickening to be a main feature (around 43.1%) of PGIL. The percentage of hypoechoic mass in gastric lymphoma was significantly lower than in small (p < 0.05) and large bowel lymphoma (p < 0.05). Although the percentage of target lesion was higher in gastric lymphoma at the antrum than in the small and large bowels, no significant difference was noted. Conclusion: The ultrasound features of PGIL are almost always hypoechoic infiltrated lesions in the involved bowel wall. Various ultrasound patterns present according to the degree of infiltration of bowel wall, the involved region of gastrointestinal tract and the timing of examination.