Gastrointestinal Tract Lymphoma

Abstract

The gastrointestinal tract is the most common site of extranodal lymphoma, and more than 95% of gastrointestinal lymphoma cases are of the non-Hodgkin type. The stomach is the primary site of extranodal non-Hodgkin lymphoma, and more than 98% of primary gastric lymphoma (PGL) cases are diffuse large B-cell lymphomas (DLBCL) and mucosa-associated lymphoid tissue (MALT) lymphomas. Because PGL usually presents with nonspecific clinical symptoms and various endoscopic features, its diagnosis is mainly dependent on histopathologic findings. Chemotherapy is the first-line treatment choice for gastric DLBCL, whereas Helicobacter pylori eradication is the primary treatment for gastric MALT lymphoma. However, some cases of gastric adenocarcinoma resemble PGL endoscopically, complicating treatment decisions. There are various types of gastrointestinal lymphomas, such as natural killer T-cell, lymphomatous polyposis, mantle cell, follicular, immunodeficiency-related gastrointestinal, and Hodgkin. These can invade the small and large intestines. Although these lymphomas are rare, clinical outcomes differ among these types. Therefore, it is necessary for endoscopists to distinguish the clinical and endoscopic findings of the different lymphomas on biopsy to improve diagnostic accuracy.