PAEA Surgery End Of Rotation (EOR) Practice Exam

What is the most common site for extranodal lymphoma?

1. The stomach

2. The colon

3. The small bowel

4. The appendix

The correct answer is: The small bowel

The most common site for extranodal lymphoma is indeed the small bowel. This is attributable to the unique immunological environment and the high density of lymphoid tissue present in the small intestine, particularly in the Peyer's patches. Extranodal lymphomas originate outside of the lymphatic system, and the gastrointestinal tract is a frequent site due to the presence of abundant lymphoid aggregates that can give rise to lymphoma. In cases of gastrointestinal lymphoma, regions such as the stomach, colon, and appendix also can be involved, but studies and clinical observations consistently indicate that the small bowel is the most commonly affected area. Gastric lymphomas, though significant, typically follow small bowel lymphomas in frequency. The colon and appendix are involved less frequently relative to the small intestine. Therefore, recognizing the small bowel as the primary site provides clarity on the distribution patterns of extranodal lymphoma and aids in the understanding of its pathophysiology and clinical presentation.