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Gastrointestinal
Diagnosis
Small Intestine
Malignant Neoplasms
Intestinal Metastases and Lymphoma
Intestinal Metastases and Lymphoma
Atif Zaheer, MD; Michael P. Federle, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Intestinal metastases from extraintestinal primary cancer
            • Lymphoma: Malignant tumor of B lymphocytes
              • Primary small bowel (SB) lymphoma: Limited to bowel ± mesenteric nodes
              • Secondary or generalized lymphoma: Involvement of spleen, liver, or thoracic nodes

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Gross Pathologic & Surgical Features

                        • Microscopic Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    • Image Interpretation Pearls

                                      Selected References

                                      1. Gallino G et al: Surgical treatment of melanoma metastases to the small bowel: a single cancer referral center real-life experience. Eur J Surg Oncol. 47(2):409-15, 2021
                                      2. Baiu I et al: Minimally invasive small bowel cancer surgery. Surg Oncol Clin N Am. 28(2):273-83, 2019
                                      3. Lee MH et al: Clinical time course and CT detection of metastatic disease to the small bowel. Abdom Radiol (NY). 44(6):2104-10, 2019
                                      4. Shirwaikar Thomas A et al: Gastrointestinal lymphoma: the new mimic. BMJ Open Gastroenterol. 6(1):e000320, 2019
                                      5. Pezzella M et al: Detecting a rare composite small bowel lymphoma by magnetic resonance imaging coincidentally: a case report with radiological, surgical and histopathological features. Int J Surg Case Rep. 46:50-5, 2018
                                      6. Baderca F et al: Mucosal melanomas in the elderly: challenging cases and review of the literature. Clin Interv Aging. 9:929-37, 2014
                                      7. Biagi F et al: Low incidence but poor prognosis of complicated coeliac disease: a retrospective multicentre study. Dig Liver Dis. 46(3):227-30, 2014
                                      8. Ilus T et al: Incidence of malignancies in diagnosed celiac patients: a population-based estimate. Am J Gastroenterol. 109(9):1471-7, 2014
                                      9. Masselli G et al: Small-bowel neoplasms: prospective evaluation of MR enteroclysis. Radiology. 251(3):743-50, 2009
                                      10. Buckley O et al: The imaging of coeliac disease and its complications. Eur J Radiol. 65(3):483-90, 2008
                                      11. Pickhardt PJ et al: Evaluation of submucosal lesions of the large intestine: part 1. Neoplasms. Radiographics. 27(6):1681-92, 2007
                                      12. Sailer J et al: MDCT of small bowel tumours. Cancer Imaging. 7:224-33, 2007
                                      13. Gore RM et al: Diagnosis and staging of small bowel tumours. Cancer Imaging. 6:209-12, 2006
                                      14. Mendelson RM et al: Primary gastrointestinal lymphomas: a radiological-pathological review. Part 2: small intestine. Australas Radiol. 50(2):102-13, 2006
                                      15. Ohashi S et al: Education and imaging. Gastrointestinal: MALT lymphoma of the terminal ileum. J Gastroenterol Hepatol. 21(9):1495, 2006
                                      16. Horton KM et al: Multidetector-row computed tomography and 3-dimensional computed tomography imaging of small bowel neoplasms: current concept in diagnosis. J Comput Assist Tomogr. 28(1):106-16, 2004
                                      17. Sheth S et al: Mesenteric neoplasms: CT appearances of primary and secondary tumors and differential diagnosis. Radiographics. 23(2):457-73; quiz 535-6, 2003
                                      18. Buckley JA et al: CT evaluation of small bowel neoplasms: spectrum of disease. Radiographics. 18(2):379-92, 1998
                                      19. Balthazar EJ et al: CT of small-bowel lymphoma in immunocompetent patients and patients with AIDS: comparison of findings. AJR Am J Roentgenol. 168(3):675-80, 1997
                                      20. Rubesin SE et al: Non-Hodgkin lymphoma of the small intestine. Radiographics. 10(6):985-98, 1990
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Clinical Issues

                                              TERMINOLOGY

                                              • Definitions

                                                • Intestinal metastases from extraintestinal primary cancer
                                                • Lymphoma: Malignant tumor of B lymphocytes
                                                  • Primary small bowel (SB) lymphoma: Limited to bowel ± mesenteric nodes
                                                  • Secondary or generalized lymphoma: Involvement of spleen, liver, or thoracic nodes

                                              IMAGING

                                              • General Features

                                                • Radiographic Findings

                                                  • CT Findings

                                                    • Imaging Recommendations

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          • Gross Pathologic & Surgical Features

                                                            • Microscopic Features

                                                              CLINICAL ISSUES

                                                              • Presentation

                                                                • Demographics

                                                                  • Natural History & Prognosis

                                                                    • Treatment

                                                                      DIAGNOSTIC CHECKLIST

                                                                      • Consider

                                                                        • Image Interpretation Pearls

                                                                          Selected References

                                                                          1. Gallino G et al: Surgical treatment of melanoma metastases to the small bowel: a single cancer referral center real-life experience. Eur J Surg Oncol. 47(2):409-15, 2021
                                                                          2. Baiu I et al: Minimally invasive small bowel cancer surgery. Surg Oncol Clin N Am. 28(2):273-83, 2019
                                                                          3. Lee MH et al: Clinical time course and CT detection of metastatic disease to the small bowel. Abdom Radiol (NY). 44(6):2104-10, 2019
                                                                          4. Shirwaikar Thomas A et al: Gastrointestinal lymphoma: the new mimic. BMJ Open Gastroenterol. 6(1):e000320, 2019
                                                                          5. Pezzella M et al: Detecting a rare composite small bowel lymphoma by magnetic resonance imaging coincidentally: a case report with radiological, surgical and histopathological features. Int J Surg Case Rep. 46:50-5, 2018
                                                                          6. Baderca F et al: Mucosal melanomas in the elderly: challenging cases and review of the literature. Clin Interv Aging. 9:929-37, 2014
                                                                          7. Biagi F et al: Low incidence but poor prognosis of complicated coeliac disease: a retrospective multicentre study. Dig Liver Dis. 46(3):227-30, 2014
                                                                          8. Ilus T et al: Incidence of malignancies in diagnosed celiac patients: a population-based estimate. Am J Gastroenterol. 109(9):1471-7, 2014
                                                                          9. Masselli G et al: Small-bowel neoplasms: prospective evaluation of MR enteroclysis. Radiology. 251(3):743-50, 2009
                                                                          10. Buckley O et al: The imaging of coeliac disease and its complications. Eur J Radiol. 65(3):483-90, 2008
                                                                          11. Pickhardt PJ et al: Evaluation of submucosal lesions of the large intestine: part 1. Neoplasms. Radiographics. 27(6):1681-92, 2007
                                                                          12. Sailer J et al: MDCT of small bowel tumours. Cancer Imaging. 7:224-33, 2007
                                                                          13. Gore RM et al: Diagnosis and staging of small bowel tumours. Cancer Imaging. 6:209-12, 2006
                                                                          14. Mendelson RM et al: Primary gastrointestinal lymphomas: a radiological-pathological review. Part 2: small intestine. Australas Radiol. 50(2):102-13, 2006
                                                                          15. Ohashi S et al: Education and imaging. Gastrointestinal: MALT lymphoma of the terminal ileum. J Gastroenterol Hepatol. 21(9):1495, 2006
                                                                          16. Horton KM et al: Multidetector-row computed tomography and 3-dimensional computed tomography imaging of small bowel neoplasms: current concept in diagnosis. J Comput Assist Tomogr. 28(1):106-16, 2004
                                                                          17. Sheth S et al: Mesenteric neoplasms: CT appearances of primary and secondary tumors and differential diagnosis. Radiographics. 23(2):457-73; quiz 535-6, 2003
                                                                          18. Buckley JA et al: CT evaluation of small bowel neoplasms: spectrum of disease. Radiographics. 18(2):379-92, 1998
                                                                          19. Balthazar EJ et al: CT of small-bowel lymphoma in immunocompetent patients and patients with AIDS: comparison of findings. AJR Am J Roentgenol. 168(3):675-80, 1997
                                                                          20. Rubesin SE et al: Non-Hodgkin lymphoma of the small intestine. Radiographics. 10(6):985-98, 1990