Abdominal Extranodal Lymphomas: Integrating Surgical Biopsy, Immunophenotypic Profiling, and Histopathological Diagnosis for Personalized Oncological Management

Abdominal extranodal lymphomas represent a heterogeneous group of hematological malignancies characterized by diverse anatomical presentations, histopathological features, and molecular abnormalities that complicate accurate diagnosis and therapeutic selection. This narrative review examines the diagnostic relevance of surgical biopsy, immunophenotypic profiling, and comprehensive histopathological characterization in the classification and personalized management of these neoplasms. International scientific literature, including contributions from Latin American research groups, was analyzed to examine tissue acquisition strategies, diagnostic classifications, immunohistochemical markers, molecular investigations, and subtype-specific therapeutic approaches. The reviewed evidence indicates that adequate tissue sampling is essential for definitive lymphoma subclassification, particularly when morphological architecture and ancillary studies are required. Laparoscopic biopsy may provide greater specimen adequacy than percutaneous techniques in selected cases, although procedural selection should consider anatomical accessibility, clinical conditions, and diagnostic requirements. Immunophenotypic and molecular characterization allows differentiation among diffuse large B-cell lymphoma, extranodal marginal zone lymphoma, mantle cell lymphoma, follicular lymphoma, and intestinal T-cell lymphomas, each exhibiting distinct biological and therapeutic characteristics. These diagnostic differences influence the selection of systemic immunochemotherapy, targeted interventions, infection-directed treatment, and surgical management when clinically indicated. Evidence from Mexico, Peru, and Brazil contributes regional perspectives on biopsy performance and lymphoma characterization, although further multicenter investigations remain necessary. Overall, the findings support an integrated multidisciplinary approach in which appropriate tissue acquisition and precise pathological classification constitute essential foundations for personalized treatment and improved diagnostic decision-making in abdominal extranodal lymphomas.