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Management of gastrointestinal lymphomas

Arnold S Freedman, MD
Section Editor
Andrew Lister, MD, FRCP, FRCPath, FRCR
Deputy Editor
Alan G Rosmarin, MD


Primary gastrointestinal (GI) non-Hodgkin lymphoma (NHL) is a heterogeneous group of B and T cell lymphoid malignancies. The clinical features, management, and prognosis of these lymphomas differ from lymphomas of lymph node origin.

Because GI NHLs are rare, optimal treatments have not been defined. Current recommendations are primarily based upon data from case series, rather than large, randomized clinical trials. The various treatment strategies for each of the predominant types of GI NHL will be reviewed here. The clinical manifestations and diagnosis of these tumors are discussed separately. (See "Clinical presentation and diagnosis of primary gastrointestinal lymphomas".)


After a diagnosis of GI lymphoma is confirmed, a pretreatment evaluation determines the extent of disease. The specific tests included depend partly upon the location of the tumor. In addition to a history and physical examination, it is our practice to perform the following pretreatment studies:

Laboratory studies include a complete blood count with differential, HIV serology, chemistries with liver and renal function, electrolytes, and lactate dehydrogenase (LDH). Patients should undergo serologic testing for hepatitis B and hepatitis C. (See "Hepatitis B virus reactivation associated with immunosuppressive therapy".)

A contrast-enhanced computed tomography (CT) scan of the chest, abdomen and pelvis should be performed to evaluate for distant disease. The use of positron emission tomography (PET) is controversial except in cases of diffuse large B cell lymphoma (DLBCL) [1-3]. (See "Evaluation, staging, and response assessment of non-Hodgkin lymphoma", section on 'Routine imaging studies'.)

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Literature review current through: Sep 2017. | This topic last updated: Jun 23, 2017.
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