Role of computed tomography in gastrointestinal lymphoma: diagnosis, monitoring and complications

Résumé fourni par la source

Gastrointestinal lymphoma represents 5-20% of extranodal lymphomas, with the stomach and ileum being the most commonly affected sites. Due to the nonspecific symptoms, the diagnosis is often delayed, requiring histopathological confirmation and extensive imaging evaluation. We pre­sent the case of a 55-year-old female with progressive pe­ri­or­bi­tal edema, abdominal distension, weight loss and se­vere anemia. Imaging revealed circumferential ileo­ce­cal thicken­ing with aneurysmal dilatation, periorbital mas­ses, sple­no­me­galy and retroperitoneal adenopathy. His­to­patho­lo­gy confirmed a small B-cell marginal zone lym­pho­ma, and the patient was started on R-CHOP chemotherapy. Di­sease progression necessitated a switch to R-GEMOX. Com­pli­ca­tions such as intraabdominal abscess and in­tes­ti­nal obstruction required radiological and sur­gi­cal intervention. Serial computed tomography (CT) eva­lua­tions demonstrated tumor regression following treat­ment resumption. This case highlights the crucial role of CT in diagnosis, staging and treatment monitoring, as well as in detecting complications like perforation, ob­struc­tion and abscess formation. Imaging remains essential in dis­tin­guishing lymphoma from other intestinal pathologies and in guiding timely the clinical decisions.

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