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Esophageal Lymphoma Clinical Presentation

  • Author: Vivek V Gumaste, MD; Chief Editor: BS Anand, MD  more...
 
Updated: Apr 14, 2016
 

History

Most patients present with dysphagia.[9] Other symptoms include odynophagia, weight loss, chest pain, fever, fatigue, abdominal pain, and hoarseness. Patients may present with a history consistent with secondary achalasia. Patients do not typically present with fever or night sweats (B symptoms).

Patients with HIV/AIDS

In patients with HIV, one should consider an underlying esophageal lymphoma in patients with infectious esophagitis or idiopathic esophageal ulceration that is refractory to therapy. Most patients with AIDS who develop esophageal lymphoma have a prior history of opportunistic infections, such as those caused by Pneumocystis carinii (eg, P carinii pneumonia), Candida species, cytomegalovirus, and herpes simplex virus.

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Physical Examination

Physical examination is generally not helpful in diagnosing esophageal lymphoma. However, in a review of esophageal lymphoma in 10 patients without HIV, the following characteristics were noted:

  • Nine of these 10 patients appeared to have primary esophageal lymphoma
  • One of these 9 patients was found to have mild anemia; otherwise, all physical examination findings were reported as normal
  • Cervical lymphadenopathy was a prominent finding of the physical examination of the sole patient who appeared to have esophageal involvement from a previously diagnosed non-Hodgkin lymphoma

Physical examination appears to be most useful in excluding generalized peripheral lymphadenopathy, which, by definition, should not be present in primary esophageal lymphoma.

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Contributor Information and Disclosures
Author

Vivek V Gumaste, MD Associate Professor of Medicine, Mount Sinai School of Medicine of New York University; Adjunct Clinical Assistant, Mount Sinai Hospital; Director, Division of Gastroenterology, City Hospital Center at Elmhurst; Program Director of GI Fellowship (Independent Program); Regional Director of Gastroenterology, Queens Health Network

Vivek V Gumaste, MD is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association

Disclosure: Nothing to disclose.

Coauthor(s)

Manoop S Bhutani, MD Professor, Co-Director, Center for Endoscopic Research, Training and Innovation (CERTAIN), Director, Center for Endoscopic Ultrasound, Department of Medicine, Division of Gastroenterology, University of Texas Medical Branch; Director, Endoscopic Research and Development, The University of Texas MD Anderson Cancer Center

Manoop S Bhutani, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Institute of Ultrasound in Medicine, American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Rebecca C Dunphy, MD Consulting Staff, Centers for Gastroenterology

Rebecca C Dunphy, MD is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Marco G Patti, MD Professor of Surgery, Director, Center for Esophageal Diseases, University of Chicago Pritzker School of Medicine

Marco G Patti, MD is a member of the following medical societies: American Association for the Advancement of Science, American Surgical Association, American College of Surgeons, American Gastroenterological Association, American Medical Association, Association for Academic Surgery, Pan-Pacific Surgical Association, Society for Surgery of the Alimentary Tract, Society of American Gastrointestinal and Endoscopic Surgeons, Southwestern Surgical Congress, Western Surgical Association

Disclosure: Nothing to disclose.

Chief Editor

BS Anand, MD Professor, Department of Internal Medicine, Division of Gastroenterology, Baylor College of Medicine

BS Anand, MD is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Gastroenterology, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Additional Contributors

Julian Katz, MD Clinical Professor of Medicine, Drexel University College of Medicine

Julian Katz, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Law, Medicine & Ethics, American Trauma Society, Association of American Medical Colleges, Physicians for Social Responsibility

Disclosure: Nothing to disclose.

Acknowledgements

Simmy Bank, MD Chair, Professor, Department of Internal Medicine, Division of Gastroenterology, Long Island Jewish Hospital, Albert Einstein College of Medicine

Disclosure: Nothing to disclose.

Maurice A Cerulli, MD Program Director, Division of Gastroenterology and Hepatology, Program in Gastroenterology at Long Island Jewish Medical Center, Associate Professor of Clinical Medicine, Albert College of Medicine

Maurice A Cerulli, MD is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Gastroenterology, American Gastroenterological Association, American Medical Association, American Society for Gastrointestinal Endoscopy, and New York Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Reference Salary Employment

References
  1. Taal BG, Van Heerde P, Somers R. Isolated primary oesophageal involvement by lymphoma: a rare cause of dysphagia: two case histories and a review of other published data. Gut. 1993 Jul. 34(7):994-8. [Medline]. [Full Text].

  2. Madabhavi I, Patel A, Revannasiddaiah S, et al. Primary esophageal Burkitt's lymphoma: a rare case report and review of literature. Gastroenterol Hepatol Bed Bench. 2014 Fall. 7(4):230-7. [Medline]. [Full Text].

  3. Kalogeropoulos IV, Chalazonitis AN, Tsolaki S, et al. A case of primary isolated non-Hodgkin's lymphoma of the esophagus in an immunocompetent patient. World J Gastroenterol. 2009 Apr 21. 15(15):1901-3. [Medline]. [Full Text].

  4. Weeratunge CN, Bolivar HH, Anstead GM, Lu DH. Primary esophageal lymphoma: a diagnostic challenge in acquired immunodeficiency syndrome--two case reports and review. South Med J. 2004 Apr. 97(4):383-7. [Medline].

  5. Dawson IMP, Cornes JS, Morson BC. Primary malignant lymphoma of the intestinal tract. British Journal of Surgery. 1961. 49:80-9.

  6. Orvidas LJ, McCaffrey TV, Lewis JE, Kurtin PJ, Habermann TM. Lymphoma involving the esophagus. Ann Otol Rhinol Laryngol. 1994 Nov. 103(11):843-8. [Medline].

  7. Gaskin CM, Low VH, Ho LM. Isolated primary non-hodgkin's lymphoma of the esophagus. AJR Am J Roentgenol. 2001 Feb. 176(2):551-2. [Medline].

  8. Zhu Q, Xu B, Xu K, Li J, Jin XL. Primary non-Hodgkin's lymphoma in the esophagus. J Dig Dis. 2008 Nov. 9(4):241-4. [Medline].

  9. Neshatian L, Katzka DA. A hidden cause of dysphagia. primary esophageal lymphoma. Gastroenterology. 2015 Sep. 149 (3):549-50. [Medline].

  10. Ahmadzadehfar H, Sabet A, Nake K, et al. Dual-time F-18 FDG-PET/CT imaging for diagnosis of occult non-Hodgkin lymphoma in a patient with esophageal cancer. Clin Nucl Med. 2009 Mar. 34(3):168-70. [Medline].

  11. Tirumani H, Rosenthal MH, Tirumani SH, Shinagare AB, Krajewski KM, Ramaiya NH. Imaging of uncommon esophageal malignancies. Dis Esophagus. 2015 Aug-Sep. 28 (6):552-9. [Medline].

  12. Kinoshita M, Sanuki T, Yamada Y, et al. A case of esophageal mucosa-associated lymphoid tissue lymphoma diagnosed using endoscopic ultrasound-guided fine-needle aspiration. Nihon Shokakibyo Gakkai Zasshi. 2016. 113 (1):63-70. [Medline].

  13. Hosaka S, Nakamura N, Akamatsu T, Fujisawa T, Ogiwara Y, Kiyosawa K, et al. A case of primary low grade mucosa associated lymphoid tissue (MALT) lymphoma of the oesophagus. Gut. 2002 Aug. 51(2):281-4. [Medline].

  14. Wotherspoon AC. Extragastric MALT lymphoma. Gut. 2002 Aug. 51(2):148-9. [Medline].

  15. Wu N, Pang L, Chen Z, et al. Primary esophageal CD30-positive ALK-positive anaplastic large cell lymphoma: a case report and literature review. J Gastrointest Cancer. 2011 Mar. 42(1):57-60. [Medline].

  16. Kudo K, Ota M, Narumiya K, Shirai Y, Ohki T, Yamamoto M. Primary esophageal mucosa-associated lymphoid tissue lymphoma treated by endoscopic submucosal dissection. Dig Endosc. 2014 May. 26(3):478-81. [Medline].

  17. Agha FP, Schnitzer B. Esophageal involvement in lymphoma. Am J Gastroenterol. 1985 Jun. 80(6):412-6. [Medline].

  18. Bernal A, del Junco GW. Endoscopic and pathologic features of esophageal lymphoma: a report of four cases in patients with acquired immune deficiency syndrome. Gastrointest Endosc. 1986 Apr. 32(2):96-9. [Medline].

  19. Bolondi L, De Giorgio R, Santi V, Paparo GF, Pileri S, Di Febo G, et al. Primary non-Hodgkin's T-cell lymphoma of the esophagus. A case with peculiar endoscopic ultrasonographic pattern. Dig Dis Sci. 1990 Nov. 35(11):1426-30. [Medline].

  20. Brady LW, Asbell SO. Malignant lymphoma of the gastrointestinal tract. Erskine Memorial Lecture, 1979. Radiology. 1980 Nov. 137(2):291-8. [Medline].

  21. Cappell MS, Botros N. Predominantly gastrointestinal symptoms and signs in 11 consecutive AIDS patients with gastrointestinal lymphoma: a multicenter, multiyear study including 763 HIV-seropositive patients. Am J Gastroenterol. 1994 Apr. 89(4):545-9. [Medline].

  22. Chadha KS, Hernandez-Ilizaliturri FJ, Javle M. Primary esophageal lymphoma: case series and review of the literature. Dig Dis Sci. 2006 Jan. 51(1):77-83. [Medline].

  23. Chow DC, B1eikh SH, Eickhoff L, Soloway GN, Saul Z. Primary esophageal lymphoma in AIDS presenting as a nonhealing esophageal ulcer. Am J Gastroenterol. 1996 Mar. 91(3):602-3. [Medline].

  24. Field SP, Sachar DB, Childs CC, Rubin KP. Steroid-responsive dysphagia: a clue to the diagnosis of esophageal lymphoma. Mt Sinai J Med. 1984 Jul-Aug. 51(4):451-4. [Medline].

  25. Finn DG. Lymphoma of the head and neck and acquired immunodeficiency syndrome: clinical investigation and immunohistological study. Laryngoscope. 1995 Apr. 105(4 Pt 2 Suppl 68):1-18. [Medline].

  26. Gilman AG, Rall TW, Nies AS. The Pharmacological Basis of Therapeutics. 8th ed. New York: McGraw-Hill Inc; 1993.

  27. Gupta NM, Goenka MK, Jindal A, Behera A, Vaiphei K. Primary lymphoma of the esophagus. J Clin Gastroenterol. 1996 Oct. 23(3):203-6. [Medline].

  28. Herrmann R, Panahon AM, Barcos MP, Walsh D, Stutzman L. Gastrointestinal involvement in non-Hodgkin's lymphoma. Cancer. 1980 Jul 1. 46(1):215-22. [Medline].

  29. Hricak H, Thoeni RF, Margulis AR, Eyler WR, Francis IR. Extension of gastric lymphoma into the esophagus and duodenum. Radiology. 1980 May. 135(2):309-12. [Medline].

  30. Kirsch HL, Cronin DW, Stein GN, Latour F, Herrera AF. Esophageal perforation. An unusual presentation of esophageal lymphoma. Dig Dis Sci. 1983 Apr. 28(4):371-4. [Medline].

  31. Kurtin PJ, Pinkus GS. Leukocyte common antigen--a diagnostic discriminant between hematopoietic and nonhematopoietic neoplasms in paraffin sections using monoclonal antibodies: correlation with immunologic studies and ultrastructural localization. Hum Pathol. 1985 Apr. 16(4):353-65. [Medline].

  32. Levine AM. Acquired immunodeficiency syndrome related lymphoma. Blood. 1992. 80:8-20.

  33. Maipang T, Panjapiyakul C, Sriplung H. Primary lymphoma of the esophagus: a case report. J Med Assoc Thai. 1992 May. 75(5):299-303. [Medline].

  34. Marnejon T, Scoccia V. The coexistence of primary esophageal lymphoma and Candida glabrata esophagitis presenting as dysphagia and odynophagia in a patient with acquired immunodeficiency syndrome. Am J Gastroenterol. 1997 Feb. 92(2):354-6. [Medline].

  35. Matsuura H, Saito R, Nakajima S, Yoshihara W, Enomoto T. Non-Hodgkin's lymphoma of the esophagus. Am J Gastroenterol. 1985 Dec. 80(12):941-6. [Medline].

  36. Mengoli M, Marchi M, Rota E, Bertolotti M, Gollini C, Signorelli S. Primary non-Hodgkin's lymphoma of the esophagus. Am J Gastroenterol. 1990 Jun. 85(6):737-41. [Medline].

  37. Moses AE, Rahav G, Bloom AI, Okon E, Polliack A, Maayan S, et al. Primary lymphoma of the esophagus in a patient with AIDS. J Clin Gastroenterol. 1995 Dec. 21(4):327-8. [Medline].

  38. Moss S, Valentine CB, Carey PB, Hind CR. Dysphagia in an HIV-positive man. Postgrad Med J. 1995 Apr. 71(834):247-8. [Medline].

  39. Nagrani M, Lavigne BC, Siskind BN, Knisley RE, Traube M. Primary non-Hodgkin's lymphoma of the esophagus. Arch Intern Med. 1989 Jan. 149(1):193-5. [Medline].

  40. Park S, Jeen YT, Kwon YD, et al. Successfully cured primary esophageal lymphoma in a patient with acquired immune deficiency syndrome (AIDS). Endoscopy. 2009. 41 suppl 2:E148-9. [Medline]. [Full Text].

  41. Safai B, Diaz B, Schwartz J. Malignant neoplasms associated with human immunodeficiency virus infection. CA Cancer J Clin. 1992 Mar-Apr. 42(2):74-95. [Medline].

  42. Salerno CT, Kreykes NS, Rego A, Maddaus MA. Primary esophageal lymphoma: a diagnostic challenge. Ann Thorac Surg. 1998 Oct. 66(4):1418-20. [Medline].

  43. Saddoughi SA, Taswell J, Harmsen WS, et al. Surgical resection of rare esophageal cancers. Ann Thorac Surg. 2016 Jan. 101 (1):311-5. [Medline].

  44. Ye ZY, Cao QH, Liu F, et al. Primary esophageal extranasal NK/T cell lymphoma with biphasic morphology: a case report and literature review. Medicine (Baltimore). 2015 Jul. 94 (28):e1151. [Medline].

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