Analysis of atypical computed tomography features of primary small intestinal lymphoma

Abstract

Objective To investigate the atypical computed tomography (CT) features of primary small intestinal lymphoma (PSIL), and its correlation with pathology. Methods From July 2007 to June 2018, at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, the clinical features and CT imaging data of 29 histopathologically diagnosed PSIL with atypical CT features were retrospectively analyzed. Results A total of 29 cases were all confirmed as Non-Hodgkin′s lymphoma including 23 cases of B cell lymphoma and six cases of peripheral T cell lymphoma. In 24 PSIL patients, the intestinal wall was unevenly thickened. While five cases had intra- and extra-intestinal masses. Images of four PSIL patients showed heterogeneous density at unenhanced CT scan, five cases presented with heterogeneous mild to moderate enhancement and five cases demonstrated with obvious enhancement at portal venous phase. Multiple ulcers in mucosa were found in 20 cases, and obviously abnormal mucosal enhancement was found in five cases, and 13 cases showed rough serosa layer of intestinal wall and the fat gap around the intestinal wall disappeared. Adjacent organs were involved in four cases and intestinal obstruction occurred in eight cases. Conclusion The atypical imaging of PSIL can be heterogeneous density of the lesion, heterogeneous or obvious enhancement at enhanced scan, multiple ulcers on the mucosal surface, thickening of the mucosal surface, blurred peripheral fat space, involvement of adjacent organs and intestinal obstruction. Key words: Primary lymphoma; Small intestinal; Computed tomography