Primary gastrointestinal lymphoma

Table 2 Characteristic features of gastrointestinal lymphomas

Region	Age (yr)	GIL (%)	Sex	Predilection site	Etiological/risk factors	Presenting symptoms	Common pathological subtypes	Radiographic features
Oropharyngeal	> 50	-	M > F	Tonsil, nasopharynx1, base of tongue	EBV	Dysphagia, dyspnea, painless mass, ulcer, oral/hearing pain, B symptoms rare	DLBCL, EMZL/MALT, PTCL, FL, MCL, ENKL, HD	Lobular mass, ulcers
Esophagus	Variable	< 1	-	Mid and lower third	EBV, HIV	Dysphagia, odynophagia, weight loss, epigastric/chest pain, pneumonia, bleeding rare, B symptoms rare	DLBCL, MALT lymphoma, HD, MCL, T-cell lymphoma	Stricture, ulcerated mass, submucosal nodules, varicoid-like, achalasia-like, aneurysmal, fistula formation
Stomach	> 50	60-75	M > F	Antrum	H. pylori (MALT lymphoma), HTLV-1, HBV (DLBCL), EBV, HCV	Epigastric pain, dysphagia, nausea, vomiting, weight loss, abdominal mass, gastrointestinal bleeding, obstruction, perforation, B symptoms rare	DLBCL, MALT, PTCL	Ulcers, polypoid mass, thickened fold, mucosal nodularity, linitis plastica-like
Small intestine	Variable	20-30	Usually, M > F	Ileum, jejunum, duodenum, multiple sites	Celiac disease (EATL), C. jejuni (IPSID), EBV, HIV/AIDS	Abdominal pain, nausea, vomiting, weight loss, GI bleeding, obstructive symptoms, intussusceptions, perforation, diarrhea (in IPSID), B symptoms rare	DLBLCL, MALT, EATL, MCL, Burkitt lymphoma, FL, IPSID, PTCL, ENKL	Polypoid mass, multiple nodules, infiltrative form, ulcer, excavation, fistulization, extraluminal mass, mucosal thickening, strictures
Colon/rectum	50-70	6-12	M > F	Caecum, ascending colon, rectum	Celiac disease (EATL), EBV, H. pylori (MALT lymphoma)	Abdominal pain, weight loss, abdominal mass, lower GI bleeding, obstruction, perforation	DLBCL, MALT, EATL, MCL, PTCL, Burkitt lymphoma	Polypoid mass, ulcers, mucosal nodularity, cavitary mass, mucosal thickening, strictures, aneurysmal

¹Included here though usually not applicable. GIL: Gastrointestinal lymphoma; EBV: Epstein Barr virus; DLBCL: Diffuse large B cell lymphoma; EMZL: Extranodal marginal-zone lymphoma; PTCL: Peripheral T cell lymphoma; FL: Follicular lymphoma; EATL: Enteropathy-associated T-cell lymphoma; MCL: Mantle cell lymphoma; IPSID: Immunoproliferative small intestinal disease; HD: Hodgkin’s disease; HTLV-1: Human T-cell lymphotropic virus-1; HCV: Hepatitis C virus; HBV: Hepatitis B virus; H. pylori: Helicobacter pylori; C. jejuni: Campylobacter jejuni; HIV: Human immunodeficiency virus; AIDS: Acquired immune deficiency syndrome; ENKL: Extranodal NK/T-cell lymphoma.