OBJECTIVE. We undertook this study to assess how well double-contrast radiography and CT allow radiologists to differentiate low-grade from high-grade mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach. MATERIALS AND METHODS.We retrospectively reviewed the upper gastrointestinal radiographs and contrast-enhanced CT scans of 57 patients with pathologically proven primary gastric lymphoma (low-grade [ n = 29] and high-grade [ n = 28] MALT lymphoma).RESULTS. On upper gastrointestinal radiography, ulceration (39%) was the most common finding in low-grade lymphoma, whereas polypoid appearance (38%) was the most common in high-grade lymphoma. In the 29 patients (33 lesions) with low-grade MALT lymphoma, upper gastrointestinal radiography revealed 13 ulcerative lesions (39%), 10 nodular lesions (30%), four infiltrative lesions (12%), two polypoid lesions (6%), and four combined lesions (12%). In the 28 patients (29 lesions) with high-grade lymphoma, upper gastrointestinal radiography revealed 11 polypoid lesions (38%), nine infiltrative lesions (31%), six ulcerative lesions (20%), one nodular lesion (3%), and two combined lesions (7%). On CT, thickening of the gastric wall in low-grade lymphoma (range, 0.3-2.5 cm; mean, 0.8 cm) was much less than that in high-grade lymphoma (range, 0.7-8.0 cm; mean, 2.5 cm). Abdominal lymphadenopathy was less frequent in low-grade lymphoma (14%) than in high-grade lymphoma (75%).CONCLUSION. Most low-grade lymphomas show superficial spreading lesions, such as mucosal nodularity, shallow ulcer, and minimal fold thickening, on upper gastrointestinal radiography, whereas most high-grade lymphomas show mass-forming lesions or severe fold thickening.

Non-Hodgkin's lymphoma very rarely involves the esophagus, occurring in less than 1% of patients with gastrointestinal lymphoma. A few cases of mucosa-associated lymphoid tissue (MALT) lymphoma of the esophagus have been reported in the English literature. To our knowledge, there has been no report of MALT lymphoma of the esophagus coexistent with bronchus-associated lymphoid tissue lymphoma (BALT) of the lung. This report details the radiological and clinical findings of this first concurrent case.

Imaging findings of secondary hepatic lymphoma have been reported as variable, ranging from single or multiple small nodules to diffuse infiltrative tumor patterns. We hear present a rare case report concerning aggressive B cells, secondary Burkitt's lymphoma in non-AIDS demonstrating a surprising periportal lymphoma infiltration, without upper abdominal lymphadenopathy or splenomegaly on the sonography and CT scans. Clinically, the case was characterized by atypical and highly aggressive course, with the patient presenting an abruptly developed obstructive jaundice with rapidly deteriorating hepatic function that could be indicative of cholestatic hepatitis, which differs in its clinical manifestations from hepatic lymphoma without functional deterioration in respect of its non-tissue destructive growth pattern. We suggest that hepatic lymphoma can sometimes be consistent with periportal infiltrating homogeneous mass, with no lymphadenopathy or splenomegaly on the imaging examination, with a predictable aggressive clinical course of the disease and poor prognosis.

Our results show that ultrasound-guided core needle biopsy can be a safe and accurate method for diagnosing thyroid lymphoma and may be a suitable replacement for diagnostic thyroid surgery.