Diffuse Nodular SB Mucosa Lymphangiectasia

• Primary(anomalous lymphatic dilitation) or secondary(dilitation from lympatic obstruction) forms are indistinguishable radiographically. Cause thickening of SB wall/folds and nodular mucosal pattern

• DDX diffuse nodular SB mucosa

Tumor- lymphoma, mets melanoma
Infection/Inflammatory – Whipple, Crohn, Histo, nodular lymphoid hyperplasia, amyloid
Congenital – waldenstorm’s macroglobulinemia, polyposis
Metabolic
Vascular – lymphangiectasia, ischemia(edema/pneumatosis)
Other - Mastocytosis

• Waldenstrom’s macroglobulinemia – idiopathic plasma cell dyscrasia. Associated HSM, lymphadenopathy, bleeding, anemia
• Mastocytosis – mast cell proliferation bone, skin, GI tract. Associated symptoms from release of histamine from mast cells
• Nodular lymphoid hyperplasia – can be a normal finding in children. Adults, more commonly associated with infection or inflammatory process

Duke DDX Multiple SB Masses
Polyposes

• Benign neoplasms – hemangioma, leiomyoma, neurofibroma
• FB
• Malignant neoplasms – carcinoid, lymphoma, mets