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MR Enterography of Small-Bowel Lymphoma: Potential for Suggestion of Histologic Subtype and the Presence of Underlying Celiac Disease

¹ Department of Radiology, University College Hospital, Newcastle Rd., Galway, Ireland.
² Present address: Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, 10945 Le Conte Ave., Peter V. Ueberroth Bldg., Ste. 3371, Los Angeles, CA 90095-7206.

View larger version (147K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1A —Coronal (A) and axial (B) images from MR enterographic study in 61-year-old man with celiac-associated low-grade follicular B-cell non-Hodgkin's lymphoma (patient 5 in Table 1). Two areas of circumferential jejunal and ileal fold thickening (arrows).

View larger version (114K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1B —Coronal (A) and axial (B) images from MR enterographic study in 61-year-old man with celiac-associated low-grade follicular B-cell non-Hodgkin's lymphoma (patient 5 in Table 1). Also present is aneurysmal dilatation, abnormal wall thickening, and irregular mucosal surface of lumen in one involved loop (arrowhead).

View larger version (142K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2 —Axial true fast imaging with steady-state free precession image in 72-year-old woman with high-grade T-cell lymphoma (patient 6 in Table 1). Note circumferential ileal loop thickening (arrowhead) in absence of mesenteric involvement.

View larger version (118K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3 —T2 coronal true fast imaging with steady-state free precession MR image in 50-year-old man with T-cell non-Hodgkin's lymphoma and background of celiac disease (patient 7 in Table 1) shows long segment of proximal ileum with abnormal diffuse thickening and associated luminal aneurysmal dilatation (arrow).

View larger version (188K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4A —T2 true fast imaging with steady-state free precession MR images of patients with small-bowel lymphoma and celiac disease. Coronal image in 46-year-old woman (patient 9 in Table 1) with mucosa-associated lymphoid tissue (MALT) shows short segment of jejunum with abnormal thickening, smooth margins, and luminal narrowing with loss of normal mucosal folds (arrow).

View larger version (109K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4B —T2 true fast imaging with steady-state free precession MR images of patients with small-bowel lymphoma and celiac disease. Axial image of 73-year-old man (patient 8 in Table 1) with high-grade T-cell lymphoma shows abnormally thickened ileal segment with smooth margins (arrow).

View larger version (109K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5A —Follicular non-Hodgkin's lymphoma of proximal ileum in 51-year-old woman (patient 4 in Table 1). MR images show circumferential eccentric mural thickening (arrows) with loop dilatation, irregular margins, and mucosal folds. In addition, mesenteric nodal mass (arrowheads) is present.

View larger version (135K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5B —Follicular non-Hodgkin's lymphoma of proximal ileum in 51-year-old woman (patient 4 in Table 1). MR images show circumferential eccentric mural thickening (arrows) with loop dilatation, irregular margins, and mucosal folds. In addition, mesenteric nodal mass (arrowheads) is present.

View larger version (131K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6 —68-year-old man (patient 10 in Table 1) with high-grade T-cell Hodgkin's lymphoma of jejunum (arrow) and celiac disease. MR image shows luminal narrowing with proximal lumen dilatation. Also, mucosal surface ulceration (arrowheads) is present.

View larger version (143K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7A —64-year-old woman with low-grade B-cell non-Hodgkin's lymphoma (patient 2 in Table 1). There is eccentric irregular mural thickening with ileal luminal narrowing (arrow). Note that thickening is predominantly mesenteric in distribution (arrowheads).

View larger version (147K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7B —64-year-old woman with low-grade B-cell non-Hodgkin's lymphoma (patient 2 in Table 1). There is also eccentric mural thickening on one ileal loop (arrow) with attenuation of mucosal folds and luminal narrowing (arrowhead).

View larger version (134K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 8A —44-year-old woman (patient 3 in Table 1) with follicular B-cell non-Hodgkin's lymphoma. MR images show two discrete areas of involvement in proximal (A) and distal (B) ileum. Note circumferential eccentric thickening (arrowheads) in both areas with some surface irregularity. There is also mesenteric involvement (arrows).

View larger version (147K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 8B —44-year-old woman (patient 3 in Table 1) with follicular B-cell non-Hodgkin's lymphoma. MR images show two discrete areas of involvement in proximal (A) and distal (B) ileum. Note circumferential eccentric thickening (arrowheads) in both areas with some surface irregularity. There is also mesenteric involvement (arrows).

View larger version (147K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 9A —85-year-old woman with high-grade B-cell non-Hodgkin's lymphoma of duodenum (patient 1 in Table 1). Note circumferential, irregular eccentric mural thickening (arrowheads). Mesenteric fat infiltration (arrows) is also present.

View larger version (118K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 9B —85-year-old woman with high-grade B-cell non-Hodgkin's lymphoma of duodenum (patient 1 in Table 1). Note circumferential, irregular eccentric mural thickening (arrowheads). Mesenteric fat infiltration (arrows) is also present.

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