Gastrointestinal lymphoma: Sonographic aspects

The importance of ultrasound for the diagnosis of gastrointestinal malignant lymphoma is explained by the fact that ultrasound is the first radiologic procedure after clinical examination which is used in diagnostic workup. The main sonographic findings are based on the radiologic appearance of the bowel wall and differentiation of its layers, starlike configuration of the narrowed echogenic center and hypoechoic wall thickening of varying extent. Typically, malignant lymphoma of the gastrointestinal wall shows as hypoechoic circumferential intestinal infiltration. Other findings such as exclusive mucosal involvement, transmural segmental infiltration or bulky tumor are rare. Characteristically, peristalsis is unaffected until a late stage in patients with gastrointestinal malignant lymphoma. These sonographic findings in patients with gastrointestinal lymphoma are not alone specific for the disease, but tile combinations of various abnormalities found by ultrasound are helpful in selecting appropriate radiologic, endoscopic and biopsy procedures in the further diagnostic workup.