Capsule endoscopy in gastrointestinal lymphomas

Background and Study Aims: Capsule endoscopy (CE) is a new procedure for small-bowel imaging. The potential contribution of this method to the diagnosis and staging of gastrointestinal lymphomas has not yet been evaluated. The aim of this prospective study was to assess the frequency and morphology of different forms of intestinal pathology in patients with gastrointestinal lymphomas. Patients and Methods: Commercially available capsule video endoscopes were administered to 27 patients (16 men and 11 women, aged 27 - 77) with known gastrointestinal lymphomas. CE was also carried out in 30 control individuals. Results: All seven patients with primary intestinal lymphomas who were examined were found to have pathological findings on CE - four with ulcerations, four with nodes, three with villous atrophy, and one with plaques/white villi. One patient with severe diarrhea was examined three times before and after chemo-therapy, and improvement of the lesions was evident, as well as resolution of diarrhea. Twenty patients with gastric lymphoma were examined (16 with low-grade and four with high-grade B cell lymphomas). The capsule did not leave the stomach in three patients, suggesting impaired motility. The small-bowel transit times were 261 +/- 41 min for intestinal lymphoma, 245 +/- 62 min for gastric lymphoma, and 224 +/- 82 min for controls (P > 0.05). Five of the 20 patients with gastric lymphoma had pathological findings in the intestine - three with plaques/white villi, two with nodes, and two with villous atrophy. In two patients, subsequent biopsies revealed secondary follicular lymphoma and high-grade lymphoma, respectively. Conclusions: CE is a valuable diagnostic tool for defining the extent of bowel involvement and assessing the efficacy of treatment in patients with gastrointestinal lymphoma.