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Erschienen in: Der Radiologe 1/2018

08.12.2017 | Computertomografie | Leitthema

Extranodale abdominale Lymphomerkrankungen

verfasst von: PD Dr. T. F. Weber, Dr. S. Dietrich, Dr. J. Nattenmüller

Erschienen in: Die Radiologie | Ausgabe 1/2018

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Zusammenfassung

Hintergrund

Extranodale Lymphommanifestationen treten in bis zu 40 % der Non-Hodgkin-Lymphome (NHL) auf. Eine Zunahme von extranodalen Lymphommanifestationen ist zu beobachten.

Fragestellung

Radiologische Zeichen von Lymphommanifestationen in den parenchymatösen Oberbauchorganen sowie dem Gastrointestinaltrakt und der Peritonealhöhle unter Berücksichtigung des klinischen Kontexts werden zusammengefasst.

Material und Methode

Es wurde eine selektive Literaturrecherche mit Analyse von Grundlagen- und Übersichtsarbeiten durchgeführt. Klinische Leitlinien werden diskutiert.

Ergebnisse

Extranodale abdominale Lymphommanifestationen treten meist sekundär im Rahmen von fortgeschrittenen NHL auf. Sie betreffen am häufigsten den Gastrointestinaltrakt und die Leber. Bei immunkompromittierten Patienten ist der Extranodalbefall häufiger als bei immunkompetenten.

Schlussfolgerung

Die radiologischen Befunde von extranodalen abdominalen Lymphomerkrankungen sind sehr variabel, so dass das Lymphom stets eine Differenzialdiagnose bei unklaren abdominalen Krankheitsbildern ist.
Literatur
1.
Zurück zum Zitat Otter R, Gerrits WB, van der Sandt MM, Hermans J, Willemze R (1989) Primary extranodal and nodal non-Hodgkin’s lymphoma. A survey of a population-based registry. Eur J Cancer Clin Oncol 25:1203–1210CrossRefPubMed Otter R, Gerrits WB, van der Sandt MM, Hermans J, Willemze R (1989) Primary extranodal and nodal non-Hodgkin’s lymphoma. A survey of a population-based registry. Eur J Cancer Clin Oncol 25:1203–1210CrossRefPubMed
2.
Zurück zum Zitat Ma J, Wang Y, Zhao H et al (2014) Clinical characteristics of 26 patients with primary extranodal Hodgkin lymphoma. Int J Clin Exp Pathol 7:5045–5050PubMedPubMedCentral Ma J, Wang Y, Zhao H et al (2014) Clinical characteristics of 26 patients with primary extranodal Hodgkin lymphoma. Int J Clin Exp Pathol 7:5045–5050PubMedPubMedCentral
3.
Zurück zum Zitat Newton R, Ferlay J, Beral V, Devesa SS (1997) The epidemiology of non-Hodgkin’s lymphoma: comparison of nodal and extra-nodal sites. Int J Cancer 72:923–930CrossRefPubMed Newton R, Ferlay J, Beral V, Devesa SS (1997) The epidemiology of non-Hodgkin’s lymphoma: comparison of nodal and extra-nodal sites. Int J Cancer 72:923–930CrossRefPubMed
4.
Zurück zum Zitat Swerdlow SH, Campo E, Pileri SA et al (2016) The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 127:2375–2390CrossRefPubMedPubMedCentral Swerdlow SH, Campo E, Pileri SA et al (2016) The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 127:2375–2390CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Barrington SF, Mikhaeel NG, Kostakoglu L et al (2014) Role of imaging in the staging and response assessment of lymphoma: consensus of the International Conference on Malignant Lymphomas Imaging Working Group. J Clin Oncol 32:3048–3058CrossRefPubMedPubMedCentral Barrington SF, Mikhaeel NG, Kostakoglu L et al (2014) Role of imaging in the staging and response assessment of lymphoma: consensus of the International Conference on Malignant Lymphomas Imaging Working Group. J Clin Oncol 32:3048–3058CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Cheson BD, Fisher RI, Barrington SF et al (2014) Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol 32:3059–3068CrossRefPubMedPubMedCentral Cheson BD, Fisher RI, Barrington SF et al (2014) Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol 32:3059–3068CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Weiler-Sagie M, Bushelev O, Epelbaum R, Dann EJ, Haim N, Avivi I, Ben-Barak A, Ben-Arie Y, Bar-Shalom R, Israel O (2010) (18)F-FDG avidity in lymphoma readdressed: a study of 766 patients. J Nucl Med 51:25–30CrossRefPubMed Weiler-Sagie M, Bushelev O, Epelbaum R, Dann EJ, Haim N, Avivi I, Ben-Barak A, Ben-Arie Y, Bar-Shalom R, Israel O (2010) (18)F-FDG avidity in lymphoma readdressed: a study of 766 patients. J Nucl Med 51:25–30CrossRefPubMed
8.
Zurück zum Zitat Schaefer NG, Hany TF, Taverna C, Seifert B, Stumpe KDM, von Schulthess GK, Goerres GW (2004) Non-Hodgkin lymphoma and Hodgkin disease: coregistered FDG PET and CT at staging and restaging—do we need contrast-enhanced CT? Radiology 232:823–829CrossRefPubMed Schaefer NG, Hany TF, Taverna C, Seifert B, Stumpe KDM, von Schulthess GK, Goerres GW (2004) Non-Hodgkin lymphoma and Hodgkin disease: coregistered FDG PET and CT at staging and restaging—do we need contrast-enhanced CT? Radiology 232:823–829CrossRefPubMed
9.
Zurück zum Zitat Raanani P, Shasha Y, Perry C, Metser U, Naparstek E, Apter S, Nagler A, Polliack A, Ben-Bassat I, Even-Sapir E (2006) Is CT scan still necessary for staging in Hodgkin and non-Hodgkin lymphoma patients in the PET/CT era? Ann Oncol 17:117–122CrossRefPubMed Raanani P, Shasha Y, Perry C, Metser U, Naparstek E, Apter S, Nagler A, Polliack A, Ben-Bassat I, Even-Sapir E (2006) Is CT scan still necessary for staging in Hodgkin and non-Hodgkin lymphoma patients in the PET/CT era? Ann Oncol 17:117–122CrossRefPubMed
10.
Zurück zum Zitat Pinilla I, Gómez-León N, Del Campo-Del VL, Hernandez-Maraver D, Rodríguez-Vigil B, Jover-Díaz R, Coya J (2011) Diagnostic value of CT, PET and combined PET/CT performed with low-dose unenhanced CT and full-dose enhanced CT in the initial staging of lymphoma. Q J Nucl Med Mol Imaging 55:567–575PubMed Pinilla I, Gómez-León N, Del Campo-Del VL, Hernandez-Maraver D, Rodríguez-Vigil B, Jover-Díaz R, Coya J (2011) Diagnostic value of CT, PET and combined PET/CT performed with low-dose unenhanced CT and full-dose enhanced CT in the initial staging of lymphoma. Q J Nucl Med Mol Imaging 55:567–575PubMed
13.
Zurück zum Zitat Albano D, Patti C, La Grutta L et al (2016) Comparison between whole-body MRI with diffusion-weighted imaging and PET/CT in staging newly diagnosed FDG-avid lymphomas. Eur J Radiol 85:313–318CrossRefPubMed Albano D, Patti C, La Grutta L et al (2016) Comparison between whole-body MRI with diffusion-weighted imaging and PET/CT in staging newly diagnosed FDG-avid lymphomas. Eur J Radiol 85:313–318CrossRefPubMed
14.
Zurück zum Zitat Van Ufford HMEQ, Kwee TC, Beek FJ, van Leeuwen MS, Takahara T, Fijnheer R, Nievelstein RAJ, de Klerk JMH (2011) Newly diagnosed lymphoma: initial results with whole-body T1-weighted, STIR, and diffusion-weighted MRI compared with 18F-FDG PET/CT. Ajr Am J Roentgenol 196:662–669CrossRefPubMed Van Ufford HMEQ, Kwee TC, Beek FJ, van Leeuwen MS, Takahara T, Fijnheer R, Nievelstein RAJ, de Klerk JMH (2011) Newly diagnosed lymphoma: initial results with whole-body T1-weighted, STIR, and diffusion-weighted MRI compared with 18F-FDG PET/CT. Ajr Am J Roentgenol 196:662–669CrossRefPubMed
15.
Zurück zum Zitat Balbo-Mussetto A, Cirillo S, Bruna R et al (2016) Whole-body MRI with diffusion-weighted imaging: a valuable alternative to contrast-enhanced CT for initial staging of aggressive lymphoma. Clin Radiol 71:271–279CrossRefPubMed Balbo-Mussetto A, Cirillo S, Bruna R et al (2016) Whole-body MRI with diffusion-weighted imaging: a valuable alternative to contrast-enhanced CT for initial staging of aggressive lymphoma. Clin Radiol 71:271–279CrossRefPubMed
16.
Zurück zum Zitat Herrmann K, Queiroz M, Huellner MW, de Galiza Barbosa F, Buck A, Schaefer N, Stolzman P, Veit-Haibach P (2015) Diagnostic performance of FDG-PET/MRI and WB-DW-MRI in the evaluation of lymphoma: a prospective comparison to standard FDG-PET/CT. BMC Cancer 15:1002CrossRefPubMedPubMedCentral Herrmann K, Queiroz M, Huellner MW, de Galiza Barbosa F, Buck A, Schaefer N, Stolzman P, Veit-Haibach P (2015) Diagnostic performance of FDG-PET/MRI and WB-DW-MRI in the evaluation of lymphoma: a prospective comparison to standard FDG-PET/CT. BMC Cancer 15:1002CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Afaq A, Fraioli F, Sidhu H et al (2017) Comparison of PET/MRI with PET/CT in the evaluation of disease status in Lymphoma. Clin Nucl Med 42:e1CrossRefPubMedPubMedCentral Afaq A, Fraioli F, Sidhu H et al (2017) Comparison of PET/MRI with PET/CT in the evaluation of disease status in Lymphoma. Clin Nucl Med 42:e1CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Giraudo C, Raderer M, Karanikas G, Weber M, Kiesewetter B, Dolak W, Simonitsch-Klupp I, Mayerhoefer ME (2016) 18F-Fluorodeoxyglucose positron emission tomography/magnetic resonance in Lymphoma: comparison with 18F-Fluorodeoxyglucose positron emission Tomography/computed tomography and with the addition of magnetic resonance diffusion-weighted imaging. Invest Radiol 51:163–169CrossRefPubMedPubMedCentral Giraudo C, Raderer M, Karanikas G, Weber M, Kiesewetter B, Dolak W, Simonitsch-Klupp I, Mayerhoefer ME (2016) 18F-Fluorodeoxyglucose positron emission tomography/magnetic resonance in Lymphoma: comparison with 18F-Fluorodeoxyglucose positron emission Tomography/computed tomography and with the addition of magnetic resonance diffusion-weighted imaging. Invest Radiol 51:163–169CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Ghai S, Pattison J, Ghai S, O’Malley ME, Khalili K, Stephens M (2007) Primary gastrointestinal lymphoma: spectrum of imaging findings with pathologic correlation. Radiographics 27:1371–1388CrossRefPubMed Ghai S, Pattison J, Ghai S, O’Malley ME, Khalili K, Stephens M (2007) Primary gastrointestinal lymphoma: spectrum of imaging findings with pathologic correlation. Radiographics 27:1371–1388CrossRefPubMed
22.
Zurück zum Zitat Treglia G, Zucca E, Sadeghi R, Cavalli F, Giovanella L, Ceriani L (2015) Detection rate of fluorine-18-fluorodeoxyglucose positron emission tomography in patients with marginal zone lymphoma of MALT type: a meta-analysis. Hematol Oncol 33:113–124CrossRefPubMed Treglia G, Zucca E, Sadeghi R, Cavalli F, Giovanella L, Ceriani L (2015) Detection rate of fluorine-18-fluorodeoxyglucose positron emission tomography in patients with marginal zone lymphoma of MALT type: a meta-analysis. Hematol Oncol 33:113–124CrossRefPubMed
23.
Zurück zum Zitat Radan L, Fischer D, Bar-Shalom R, Dann EJ, Epelbaum R, Haim N, Gaitini D, Israel O (2008) FDG avidity and PET/CT patterns in primary gastric lymphoma. Eur J Nucl Med Mol Imaging 35:1424–1430CrossRefPubMed Radan L, Fischer D, Bar-Shalom R, Dann EJ, Epelbaum R, Haim N, Gaitini D, Israel O (2008) FDG avidity and PET/CT patterns in primary gastric lymphoma. Eur J Nucl Med Mol Imaging 35:1424–1430CrossRefPubMed
24.
Zurück zum Zitat Hedgire SS, Kudrimoti S, Oliveira IS, Nadkarni N, McDermott S, Hahn PF, Mino-Kenudson M, Harisinghani MG (2017) Extranodal lymphomas of abdomen and pelvis: imaging findings and differential diagnosis. Abdom Radiol (NY) 42:1096–1112CrossRef Hedgire SS, Kudrimoti S, Oliveira IS, Nadkarni N, McDermott S, Hahn PF, Mino-Kenudson M, Harisinghani MG (2017) Extranodal lymphomas of abdomen and pelvis: imaging findings and differential diagnosis. Abdom Radiol (NY) 42:1096–1112CrossRef
25.
Zurück zum Zitat Johnson KA, Tung K, Mead G, Sweetenham J (1998) The imaging of Burkitt’s and Burkitt-like lymphoma. Clin Radiol 53:835–841CrossRefPubMed Johnson KA, Tung K, Mead G, Sweetenham J (1998) The imaging of Burkitt’s and Burkitt-like lymphoma. Clin Radiol 53:835–841CrossRefPubMed
26.
Zurück zum Zitat Karaosmanoglu AD, Butros SR, Scott J, Blake MA (2013) PET and PET-CT imaging findings of peritoneal and omental involvement in patients with lymphoma. Clin Imaging 37:1089–1093CrossRefPubMed Karaosmanoglu AD, Butros SR, Scott J, Blake MA (2013) PET and PET-CT imaging findings of peritoneal and omental involvement in patients with lymphoma. Clin Imaging 37:1089–1093CrossRefPubMed
27.
Zurück zum Zitat Karaosmanoglu D, Karcaaltincaba M, Oguz B, Akata D, Özmen M, Akhan O (2009) CT findings of lymphoma with peritoneal, omental and mesenteric involvement: peritoneal lymphomatosis. Eur J Radiol 71:313–317CrossRefPubMed Karaosmanoglu D, Karcaaltincaba M, Oguz B, Akata D, Özmen M, Akhan O (2009) CT findings of lymphoma with peritoneal, omental and mesenteric involvement: peritoneal lymphomatosis. Eur J Radiol 71:313–317CrossRefPubMed
28.
Zurück zum Zitat O’Neill AC, Shinagare AB, Rosenthal MH, Tirumani SH, Jagannathan JP, Ramaiya NH (2014) Differences in CT features of peritoneal carcinomatosis, sarcomatosis, and lymphomatosis: retrospective analysis of 122 cases at a tertiary cancer institution. Clin Radiol 69:1219–1227CrossRefPubMed O’Neill AC, Shinagare AB, Rosenthal MH, Tirumani SH, Jagannathan JP, Ramaiya NH (2014) Differences in CT features of peritoneal carcinomatosis, sarcomatosis, and lymphomatosis: retrospective analysis of 122 cases at a tertiary cancer institution. Clin Radiol 69:1219–1227CrossRefPubMed
29.
Zurück zum Zitat Li M, Zhang L, Wu N, Huang W, Lv N (2013) Imaging findings of primary splenic lymphoma: a review of 17 cases in which diagnosis was made at splenectomy. PLOS ONE 8:e80264CrossRefPubMedPubMedCentral Li M, Zhang L, Wu N, Huang W, Lv N (2013) Imaging findings of primary splenic lymphoma: a review of 17 cases in which diagnosis was made at splenectomy. PLOS ONE 8:e80264CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Saboo SS, Krajewski KM, O’Regan KN, Giardino A, Brown JR, Ramaiya N, Jagannathan JP (2012) Spleen in haematological malignancies: spectrum of imaging findings. Br J Radiol 85:81–92CrossRefPubMedPubMedCentral Saboo SS, Krajewski KM, O’Regan KN, Giardino A, Brown JR, Ramaiya N, Jagannathan JP (2012) Spleen in haematological malignancies: spectrum of imaging findings. Br J Radiol 85:81–92CrossRefPubMedPubMedCentral
31.
Zurück zum Zitat De Jong PA, van Ufford HMQ, Baarslag H‑J, de Haas MJ, Wittebol SH, Quekel LG, de Klerk JM (2009) CT and 18F-FDG PET for noninvasive detection of splenic involvement in patients with malignant lymphoma. AJR Am J Roentgenol 192:745–753CrossRefPubMed De Jong PA, van Ufford HMQ, Baarslag H‑J, de Haas MJ, Wittebol SH, Quekel LG, de Klerk JM (2009) CT and 18F-FDG PET for noninvasive detection of splenic involvement in patients with malignant lymphoma. AJR Am J Roentgenol 192:745–753CrossRefPubMed
32.
Zurück zum Zitat Littooij AS, Kwee TC, Barber I, Granata C, de Keizer B, Beek FJ, Hobbelink MG, Fijnheer R, Stoker J, Nievelstein RA (2016) Accuracy of whole-body MRI in the assessment of splenic involvement in lymphoma. Acta Radiol 57:142–151CrossRefPubMed Littooij AS, Kwee TC, Barber I, Granata C, de Keizer B, Beek FJ, Hobbelink MG, Fijnheer R, Stoker J, Nievelstein RA (2016) Accuracy of whole-body MRI in the assessment of splenic involvement in lymphoma. Acta Radiol 57:142–151CrossRefPubMed
33.
Zurück zum Zitat Rodríguez Carnero P, Hernández Mateo P, Martín-Garre S, García Pérez Á, del Campo L (2017) Unexpected hosts: imaging parasitic diseases. Insights Imaging 8:101–125CrossRefPubMed Rodríguez Carnero P, Hernández Mateo P, Martín-Garre S, García Pérez Á, del Campo L (2017) Unexpected hosts: imaging parasitic diseases. Insights Imaging 8:101–125CrossRefPubMed
34.
Zurück zum Zitat Fishman EK, Kuhlman JE, Jones RJ (1991) CT of lymphoma: spectrum of disease. Radiographics 11:647–669CrossRefPubMed Fishman EK, Kuhlman JE, Jones RJ (1991) CT of lymphoma: spectrum of disease. Radiographics 11:647–669CrossRefPubMed
35.
Zurück zum Zitat Elsayes KM, Menias CO, Willatt JM, Pandya A, Wiggins M, Platt J (2009) Primary hepatic lymphoma: imaging findings. J Med Imaging Radiat Oncol 53:373–379CrossRefPubMed Elsayes KM, Menias CO, Willatt JM, Pandya A, Wiggins M, Platt J (2009) Primary hepatic lymphoma: imaging findings. J Med Imaging Radiat Oncol 53:373–379CrossRefPubMed
36.
Zurück zum Zitat Noronha V, Shafi NQ, Obando JA, Kummar S (2005) Primary non-Hodgkin’s lymphoma of the liver. Crit Rev Oncol Hematol 53:199–207CrossRefPubMed Noronha V, Shafi NQ, Obando JA, Kummar S (2005) Primary non-Hodgkin’s lymphoma of the liver. Crit Rev Oncol Hematol 53:199–207CrossRefPubMed
37.
Zurück zum Zitat Maher MM, McDermott SR, Fenlon HM, Conroy D, O’Keane JC, Carney DN, Stack JP (2001) Imaging of primary non-Hodgkin’s lymphoma of the liver. Clin Radiol 56:295–301CrossRefPubMed Maher MM, McDermott SR, Fenlon HM, Conroy D, O’Keane JC, Carney DN, Stack JP (2001) Imaging of primary non-Hodgkin’s lymphoma of the liver. Clin Radiol 56:295–301CrossRefPubMed
38.
Zurück zum Zitat Lee W‑K, Lau EWF, Duddalwar VA, Stanley AJ, Ho YY (2008) Abdominal manifestations of extranodal lymphoma: spectrum of imaging findings. AJR Am J Roentgenol 191:198–206CrossRefPubMed Lee W‑K, Lau EWF, Duddalwar VA, Stanley AJ, Ho YY (2008) Abdominal manifestations of extranodal lymphoma: spectrum of imaging findings. AJR Am J Roentgenol 191:198–206CrossRefPubMed
40.
Zurück zum Zitat Beeskow AB, Bach AG, Beimler M, Voigt P, Surov A (2017) Renal involvement in malignant lymphoproliferative diseases: CT imaging pattern. Rofo 189:715–718CrossRefPubMed Beeskow AB, Bach AG, Beimler M, Voigt P, Surov A (2017) Renal involvement in malignant lymphoproliferative diseases: CT imaging pattern. Rofo 189:715–718CrossRefPubMed
41.
Zurück zum Zitat Bach AG, Behrmann C, Holzhausen HJ, Katzer M, Arnold D, Spielmann RP, Surov A (2012) Prevalence and patterns of renal involvement in imaging of malignant lymphoproliferative diseases. Acta Radiol 53:343–348CrossRefPubMed Bach AG, Behrmann C, Holzhausen HJ, Katzer M, Arnold D, Spielmann RP, Surov A (2012) Prevalence and patterns of renal involvement in imaging of malignant lymphoproliferative diseases. Acta Radiol 53:343–348CrossRefPubMed
42.
Zurück zum Zitat Kumar R, Xiu Y, Mavi A, El-Haddad G, Zhuang H, Alavi A (2005) FDG-PET imaging in primary bilateral adrenal lymphoma: a case report and review of the literature. Clin Nucl Med 30:222–230CrossRefPubMed Kumar R, Xiu Y, Mavi A, El-Haddad G, Zhuang H, Alavi A (2005) FDG-PET imaging in primary bilateral adrenal lymphoma: a case report and review of the literature. Clin Nucl Med 30:222–230CrossRefPubMed
43.
Zurück zum Zitat Anand D, Lall C, Bhosale P, Ganeshan D, Qayyum A (2016) Current update on primary pancreatic lymphoma. Abdom Radiol (NY) 41:347–355CrossRef Anand D, Lall C, Bhosale P, Ganeshan D, Qayyum A (2016) Current update on primary pancreatic lymphoma. Abdom Radiol (NY) 41:347–355CrossRef
Metadaten
Titel
Extranodale abdominale Lymphomerkrankungen
verfasst von
PD Dr. T. F. Weber
Dr. S. Dietrich
Dr. J. Nattenmüller
Publikationsdatum
08.12.2017
Verlag
Springer Medizin
Erschienen in
Die Radiologie / Ausgabe 1/2018
Print ISSN: 2731-7048
Elektronische ISSN: 2731-7056
DOI
https://doi.org/10.1007/s00117-017-0329-5

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