Duodenum lymphoma

Fig. 3.54. Lymphoma of the duodenum demonstrated by confluent polypoidal protrusions and submucosal spread...

Malignant Tumours of the Stomach and Duodenum 102 Gastric Carcinoma 102 Gastric Lymphoma 103 Gastrointestinal Stromal Tumour 103 Metastasis to the Stomach 104 Primary Carcinoma of the Duodenum 104 Secondary Involvement of the Duodenum 105 Bezoars 107 References 108... 

The duodenum may be involved by direct extension of malignant neoplasms from adjacent organs or be the site of hematogenous metastases. Both gastric lymphoma and carcinoma can spread by direct infiltration through the mucosa or submucosa or less frequently through lymphatic channels via the submucosal layer (Cho et al. 1996). Radiographically detectable spread is seen in 5%-25% of adenocarcinomas and up to 40% of lymphomas, but, if present is more likely to be due to adenocarcinoma as this... 

Lymphoma may involve any portion of the stomach. Transpyloric spread of tumour into the duodenum occurs in about 30% of patients (Cho et al. 1996). Despite extensive lymphomatous infiltration, the stomach usually remains pliable and distensible without significant luminal narrowing. 

Fig. 9.20. Lymphoma. CECT shows a large extramural mass in the distal horizontal duodenum causing luminal narrowing and proximal dilatation...

Hematogenous spread from various primary tumours, mainly malignant melanoma, bronchogenic and breast carcinoma, may metastasize to the duodenum or diff use wall thickening (see Fig. 6.1.24). A metastasis may be seen on CT as an intraluminal soft tissue mass. Larger metastases often demonstrate intratumoral necrosis or cavitation, indistinguishable from lymphoma or leiomyosarcoma (JAYARAMAN et al. 2001) Zissin et al. 2002). 

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