Lymphoma of the small bowel accounts for 17 - 30% of all primary small bowel malignancies 1 and 20 - 54% of all primary gastrointestinal lymphomas 2-3.
Demographics and clinical presentation
Small bowel lymphoma is most commonly seen as secondary extra nodal involvement in widespread systemic lymphoma. When primary it is seen predominantly in well defined patient groups and the demographics therefore match those of said groups. Predisposing conditions include 1:
- coeliac disease
- organ transplant (see post transplant lymphoproliferative disorder (PTLD)
- Helicobacter pylori positive patients
Presentation is variable and includes 1 :
The type of lymphoma depends on the underlying predisposing condition.
- H pylori - mucosa-associated lymphoid tissue lymphoma (MALToma)
- PTLD - polyclonal B-cell non-Hodgkin's lymphoma (EBV associated)
- HIV - B-cell non-Hodgkin's lymphoma 3
- T-cell lymphomas are seen but are uncommon 5
Typically small bowel involves a single loop of bowel with 5-20cm of its length demonstrating 3 :
- bowel wall thickening : 1-7cm
- aneurysmal dilatation : 30%
Less frequently the disease may manifest as a solid mass lesion. Despite the extensive involvement small bowel obstruction is uncommon and perforation rare.
Regional lymph node enlargement is seen in approximately 50% of cases.
Treatment and prognosis
Most frequently the involved segment is resected, with subsequent chemoradiotherapy 2.
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- 1. Posner Mitchell C., Everett E. Vokes, Ralph R. Weichselbaum and American Cancer Society. Cancer of the upper gastrointestinal tract. PMPH-USA, 2002. ISBN: 1550091018, 9781550091014.
- 2. Ha CS, Cho MJ, Allen PK et-al. Primary non-Hodgkin lymphoma of the small bowel. Radiology. 1999;211 (1): 183-7. Radiology (full text) - Pubmed citation
- 3. Balthazar EJ, Noordhoorn M, Megibow AJ et-al. CT of small-bowel lymphoma in immunocompetent patients and patients with AIDS: comparison of findings. AJR Am J Roentgenol. 1997;168 (3): 675-80. doi:10.2214/ajr.168.3.9057513 - Pubmed citation
- 4. Rubesin SE, Gilchrist AM, Bronner M et-al. Non-Hodgkin lymphoma of the small intestine. Radiographics. 1990;10 (6): 985-98. Radiographics (abstract) - Pubmed citation
- 5. Byun JH, Ha HK, Kim AY et-al. CT findings in peripheral T-cell lymphoma involving the gastrointestinal tract. Radiology. 2003;227 (1): 59-67. Radiology (full text) - doi:10.1148/radiol.2271012129 - Pubmed citation
Synonyms & Alternative Spellings
|Synonyms or Alternative Spelling||Include in Listings?|
|Lymphoma of the small bowel||✗|
|Small bowel lymphoma||✗|
|Lymphoma of the small intestine||✗|
|Small intestinal lymphoma||✗|