Esophageal Lymphoma Clinical Presentation

Updated: Sep 03, 2019
  • Author: Victor Velocci, MD; Chief Editor: BS Anand, MD  more...
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Presentation

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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