Value of barium studies for predicting primary versus secondary non-Hodgkin's gastrointestinal lymphoma.
BACKGROUND
To determine the predictive value of a single lesion versus multifocal disease for differentiating primary and secondary gastrointestinal (GI) lymphoma on barium studies.


METHODS
Our study group consisted of 90 cases of non-Hodgkin's GI lymphoma from the radiologic archives of the Armed Forces Institute of Pathology in which barium studies had been performed. Each of those studies was reviewed jointly by two of the authors to determine in a blinded fashion whether the patients had a single lesion or multifocal disease (defined as two or more discrete lesions). Medical and pathologic records were then reviewed to determine whether these patients had primary (defined as lymphoma arising in the GI tract) or secondary (defined as disseminated lymphoma with associated GI tract involvement) GI lymphoma. The final clinical diagnosis was then correlated with the radiographic findings to test the hypothesis that a single lesion is more likely to be associated with primary GI lymphoma and that multifocal disease is more likely to be associated with secondary GI lymphoma.


RESULTS
Sixty-eight patients had a single lesion in the GI tract on barium studies; 52 (76%) of these patients had primary GI lymphoma and 16 (24%) had secondary GI lymphoma. Another 22 patients had multifocal disease on barium studies; 20 (91%) of these patients had secondary GI lymphoma and two (9%) had primary GI lymphoma.


CONCLUSIONS
The predictive value of a single lesion for primary GI lymphoma on barium studies was 76%, and the predictive value of multifocal disease for secondary GI lymphoma was 91%. Thus, our data suggest that it is often possible to differentiate these two forms of GI lymphoma on the basis of the radiographic findings.
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
C C
CC
Yoo
M S
MS
Levine
J K
JK
McLarney
S E
SE
Rubesin
H
H
Herlinger
D001466:Barium Sulfate; D003287:Contrast Media; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011859:Radiography; D012189:Retrospective Studies
D003287:Contrast Media; D001466:Barium Sulfate