Objectives To analyze the CT imaging features of extranodal natural killer/T (NK/T)-cell lymphoma, nasal type (ENKTCL-NT) involving the gastrointestinal tract (GI), and to compare them with those of Crohn’s disease (CD) and diffuse large B-cell lymphoma (DLBCL). Materials and methods Data were retrospectively collected from 17 patients diagnosed with GI ENKTCL-NT, 68 patients with CD, and 47 patients with DLBCL. The CT findings of ENKTCL-NT were analyzed and compared with those of CD and DLBCL. Data were analyzed using SPSS (version 25.0) and MedCalc (version 18.2.1). p < 0.05 was considered statistically significant. Results The 17 patients with ENKTCL-NT included 11 males (64.7%) and 6 females (35.3%) (mean age, 46.41 ± 4.12 years). The CT features of ENKTCL-NT included: circumferential symmetric thickening (100%), moderate thickening (70.6%), skip lesions (52.9%), contiguous lesion (47.1%), mucosal or layered enhancement (70.6%), moderate mural enhancement (64.7%) with non-enhanced regions (47.1%), absence of lymphadenopathy (76.5%), bowel perforation or fistula (17.6%), and peri-enteric blurred fat space (70.6%). The presence of circumferential symmetric thickening, moderate mural enhancement, and non-enhanced regions were more indicative of ENKTCL-NT than CD (17/17 vs. 17/68, 11/17 vs. 22/68, 8/17 vs. 0/68, p < 0.05). The presence of skip lesions, mucosal or layered enhancement, and absence of peri-enteric lymphadenopathy were more indicative of ENKTCL-NT than DLBCL (9/17 vs. 2/47, 12/17 vs. 1/37, 13/17 vs. 19/47, p < 0.05). Conclusion CT imaging features can provide useful information for the early diagnosis of ENKTCL-NT and effectively differentiate it from CD and DLBCL. Key Points <Emphasis Type="BoldItalic">Question</Emphasis> Extranodal natural killer/T-cell lymphoma, nasal type (ENKTCL-NT) involving the gastrointestinal tract (GI) is highly malignant but easily misdiagnosed by clinicians and endoscopic examination. <Emphasis Type="BoldItalic">Findings</Emphasis> CT could provide useful information in the diagnosis of ENKTCL-NT involving GI and in differentiating it from Crohn’s disease and diffuse large B-cell lymphoma. <Emphasis Type="BoldItalic">Clinical relevance</Emphasis> This study will help improve the ability of radiologists to diagnose ENKTCL-NT involving GI, and a more predictive diagnosis will also alert clinicians to perform multiple deep endoscopic biopsies, which will contribute to the early diagnosis and treatment of ENKTCL-NT.

The CT findings of extranodal natural killer/T-cell lymphoma, nasal type involving the gastrointestinal tract

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发表日期：

2025年1月29日

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Yi Sun,
Hailing Liu,
Peiyi Xie,
Pan Zhu,
Xiaochun Meng

摘要

Objectives

To analyze the CT imaging features of extranodal natural killer/T (NK/T)-cell lymphoma, nasal type (ENKTCL-NT) involving the gastrointestinal tract (GI), and to compare them with those of Crohn’s disease (CD) and diffuse large B-cell lymphoma (DLBCL).

Materials and methods

Data were retrospectively collected from 17 patients diagnosed with GI ENKTCL-NT, 68 patients with CD, and 47 patients with DLBCL. The CT findings of ENKTCL-NT were analyzed and compared with those of CD and DLBCL. Data were analyzed using SPSS (version 25.0) and MedCalc (version 18.2.1). p < 0.05 was considered statistically significant.

Results

The 17 patients with ENKTCL-NT included 11 males (64.7%) and 6 females (35.3%) (mean age, 46.41 ± 4.12 years). The CT features of ENKTCL-NT included: circumferential symmetric thickening (100%), moderate thickening (70.6%), skip lesions (52.9%), contiguous lesion (47.1%), mucosal or layered enhancement (70.6%), moderate mural enhancement (64.7%) with non-enhanced regions (47.1%), absence of lymphadenopathy (76.5%), bowel perforation or fistula (17.6%), and peri-enteric blurred fat space (70.6%). The presence of circumferential symmetric thickening, moderate mural enhancement, and non-enhanced regions were more indicative of ENKTCL-NT than CD (17/17 vs. 17/68, 11/17 vs. 22/68, 8/17 vs. 0/68, p < 0.05). The presence of skip lesions, mucosal or layered enhancement, and absence of peri-enteric lymphadenopathy were more indicative of ENKTCL-NT than DLBCL (9/17 vs. 2/47, 12/17 vs. 1/37, 13/17 vs. 19/47, p < 0.05).

Conclusion

CT imaging features can provide useful information for the early diagnosis of ENKTCL-NT and effectively differentiate it from CD and DLBCL.

Key Points

Question Extranodal natural killer/T-cell lymphoma, nasal type (ENKTCL-NT) involving the gastrointestinal tract (GI) is highly malignant but easily misdiagnosed by clinicians and endoscopic examination.

Findings CT could provide useful information in the diagnosis of ENKTCL-NT involving GI and in differentiating it from Crohn’s disease and diffuse large B-cell lymphoma.

Clinical relevance This study will help improve the ability of radiologists to diagnose ENKTCL-NT involving GI, and a more predictive diagnosis will also alert clinicians to perform multiple deep endoscopic biopsies, which will contribute to the early diagnosis and treatment of ENKTCL-NT.