Small intestine lymphoma occurs when non-Hodgkin’s lymphoma affects the small intestine. It can cause abdominal pain, weight loss, and fever. Treatment involves chemotherapy, surgery, or radiation therapy.

Lymphoma is a cancer that affects the body’s lymph system. The lymph system helps to protect your body from infections.

It’s possible for lymphoma to develop wherever there’s lymph tissue in the body, which can include parts of the gastrointestinal (GI) tract such as the small intestine.

Below, we’ll go into more detail about small intestine lymphoma. We’ll also outline how this type of lymphoma is diagnosed and treated as well as what’s known about the outlook for people living with small intestine lymphoma.

Small intestine lymphoma is a type of non-Hodgkin’s lymphoma (NHL) that affects lymphocytes in the small intestine. Lymphocytes are a type of white blood cell that responds to infections.

The main types of lymphocytes are B cells and T cells. B cells make antibodies in response to infections, and T cells destroy germs or abnormal cells in the body.

Generally speaking, B-cell lymphomas are more common than T-cell lymphomas. The same is also true for GI lymphomas, which include those affecting the small intestine.

Small intestine lymphoma can also be primary or secondary. “Primary” means that the lymphoma started in the lymph tissue of the small intestine. Overall, primary GI lymphomas are quite rare.

“Secondary” means that the lymphoma started elsewhere and is now in the lymph tissue of the small intestine.

The most common part of the small intestine affected by lymphoma is the ileum, which is the part of the small intestine closest to your large intestine. About 60% to 65% of small intestine lymphomas are found in the ileum.

Causes and risk factors

In general, NHL happens due to changes in DNA that cause lymphocytes to grow uncontrollably. These changes can either be inherited from your parents or acquired during your lifetime based on lifestyle and environmental factors.

GI lymphomas are often diagnosed in older adults, typically in those over the age of 60. These types of lymphoma are slightly more common in people assigned male at birth.

Other risk factors for NHL in general include:

What are the symptoms of small intestine lymphoma?

The symptoms of small intestine lymphoma may include:

Small intestine lymphomas can also lead to potentially serious complications, which may include intestinal obstruction or perforation.

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After the stomach, the small intestine is the next most common area affected by GI lymphoma.

According to a 2021 review, small intestine lymphoma makes up 20% to 30% of all GI lymphomas and also accounts for 15% to 20% of all cancers affecting the small intestine.

Like many types of cancer, small intestine lymphoma has several subtypes. The most common of these subtypes are diffuse large B-cell lymphoma (DLBCL) and mucosa-associated lymphoid tissue (MALT) lymphoma.

DLBCL is an aggressive type of lymphoma and also the most common type of NHL. MALT lymphoma is a slow-growing type of NHL that affects lymph tissue of the body’s mucosa, which lines the GI tract and other tissues.

Other less common subtypes of small intestine lymphoma can include:

The diagnosis of small intestine lymphoma starts with a doctor taking your medical history and doing a physical exam. They may also order blood tests such as:

A variety of imaging tests may also be used to view your GI tract, including:

An endoscopy may be used to identify cancerous changes in the small intestine that other imaging techniques can’t find. The procedure may be done using an endoscope or a capsule.

A biopsy may be needed to confirm the diagnosis of small intestine lymphoma. The biopsy can be done using an endoscopy or surgery.

Once collected, the biopsy sample is analyzed for the presence of lymphoma. If lymphoma is present, additional tests can be done to further characterize the lymphoma.

Whether or not NHLs like small intestine lymphoma can be cured depends on the type of NHL that you have.

Aggressive types of NHL can often be cured with treatment, but less aggressive (indolent) lymphomas usually can’t be cured. Instead, the treatment of indolent lymphoma aims to manage this type of NHL.

GI lymphomas are often treated using combination chemotherapy such as “CHOP,” which is an acronym for the following drugs:

  • cyclophosphamide
  • doxorubicin hydrochloride (hydroxydaunorubicin)
  • vincristine sulfate (Oncovin)
  • prednisone

In some cases, the targeted therapy drug rituximab (Rituxan) may also be added, which changes the acronym to “R-CHOP.”

Surgery may also be a part of small intestine lymphoma treatment to remove the cancerous lymph tissue. Surgery may also be needed to address complications of small intestine lymphoma such as intestinal obstruction.

Radiation therapy for GI lymphomas is less common due to the risk of serious side effects to the GI tract.

Indolent lymphomas may not need to be treated right away. Instead, the doctor may choose to monitor this type of NHL carefully until it causes problems and needs to be treated.

The outlook for people with small intestine lymphoma can depend on several factors, such as:

  • the type of lymphoma
  • age and overall health
  • the stage of the lymphoma
  • the type of treatment(s) used
  • how the cancer responds to treatment
  • whether the cancer returns after treatment

Research into the outlook for people with small intestine lymphoma differs. An older 2012 study of 46 people with small intestine lymphoma found that the 5-year survival rate was 64.2%. About half of the participants in this study had early stage disease.

A more recent 2020 study included 20 people, most of whom had aggressive small intestine lymphoma and surgery before chemotherapy. The study found that the 3-year overall survival for this group was 59.6%.

Small intestine lymphoma can also return after treatment, often called “relapse.” A 2018 study of 137 individuals with GI lymphoma found that 34 people, about 25%, relapsed over a follow-up period of about 18 months.

Small intestine lymphoma happens when NHL affects the small intestine, and it can cause symptoms such as abdominal pain, nausea, vomiting, and unintended weight loss.

The treatment for small intestine lymphoma can involve chemotherapy, surgery, or radiation therapy. The outlook will depend on many factors, including the type and stage of lymphoma as well as your age and overall health.

Because the symptoms of small intestine lymphoma resemble more common GI conditions, diagnosis can sometimes be delayed. Talk with a doctor if you have concerning GI symptoms, especially if they’re persistent or get worse over time.