Hematologic malignancies of the gastrointestinal luminal tract
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REVIEW
Hematologic malignancies of the gastrointestinal luminal tract Abdelrahman K. Hanafy1 · Ajaykumar C. Morani1,6 · Christine O. Menias2 · Perry J. Pickhardt3 · Akram M. Shaaban4 · Bilal Mujtaba1 · Vincent M. Mellnick5 · Khaled M. Elsayes1
© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2019
Abstract Hematologic malignancies include several lymphoproliferative and myeloproliferative disorders, many of which are frequently encountered in current health care settings. These malignancies frequently affect the gastrointestinal (GI) tract, either by secondary extranodal or extramedullary extension to the GI tract, or as a primary process arising in the GI tract. In fact, the GI tract may represent the most common extranodal site of involvement in many of them, such as lymphoma. Furthermore, in the current era of improved cancer treatment and advanced transplant procedures with increased survival, it has been quite common to encounter GI involvement by these malignancies through the disease course. Post-transplant lymphoproliferative disorder following kidney transplantation, for example, very commonly involves the GI tract. Other conditions that can involve the GI tract include multiple myeloma, plasmacytoma, myeloid sarcoma, mastocytosis, and Castleman disease. Imaging diagnosis of these malignancies can be challenging, since they are much less common than primary GI cancers and both share many common imaging features as well. However, certain imaging features, particularly in combination with a matching clinical scenario, play a pivotal role in diagnosing these conditions and directing further evaluation. In this article, we review common and rare hematologic malignancies of the GI tract and discuss their pathophysiologic, clinical, and imaging features. Keywords Gastrointestinal malignancy · Lymphoma · Hematologic malignancies · MALT lymphoma · Gastric DLBCL · Bowel lymphoma · Myeloid sarcoma · Mastocytosis · Multiple myeloma · Plasmacytoma
Introduction
* Ajaykumar C. Morani [email protected] 1
Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
2
Department of Radiology, Mayo Clinic, Scottsdale, AZ, USA
3
Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
4
Department of Diagnostic Radiology, University of Utah, Salt Lake City, UT, USA
5
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
6
Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1473, Houston, TX 77030, USA
Hematologic malignancies include a wide gamut of lymphoproliferative and myeloproliferative disorders with nodal and/or extranodal manifestations. Gastrointestinal (GI) tract is one of the most common extranodal sites to be involved [1, 2]. Reaching the diagnosis of GI hematologic malignancy on imaging is challenging, particularly
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