Small Intestinal Follicular Lymphoma with Multiple Tumor Formations Diagnosed by Double-Balloon Enteroscopy

Higuchi, Kazuyoshi; Komatsu, Kyoji; Wakamatsu, Hideki; Kawasaki, Hiroya; Murata, Makoto; Miyazaki, Keiko; Oikawa, Keisuke; Ohwada, Masanobu; Nanjo, Hiroshi; Otaka, Michiro; Watanabe, Sumio; Komatsu, Kanji

doi:10.2169/internalmedicine.46.6087

Cited by 23 publications

(13 citation statements)

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“…3) [23,25,36,38]. Endoscopic ultrasonography reveals thickening of the mucosal and submucosal layers of the intestinal wall with multiple hypoechoic granules corresponding to the lesions [19,25,26,44]. These findings suggest that each granule is an enlarged neoplastic follicle that consists of lymphoma cells in the lamina propria, which has been confirmed with histologic examination (Fig.…”

Section: Characteristic Endoscopic Findingsmentioning

confidence: 80%

“…Magnifying endoscopic examination revealed that these whitish small nodules were enlarged and fused villi and that the mucosa of these lesions had a normal appearance, which was suggestive of a subepithelial or submucosal lesion (Fig. 3) [23,25,36,38]. Endoscopic ultrasonography reveals thickening of the mucosal and submucosal layers of the intestinal wall with multiple hypoechoic granules corresponding to the lesions [19,25,26,44].…”

Section: Characteristic Endoscopic Findingsmentioning

confidence: 99%

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Gastrointestinal follicular lymphoma: review of the literature

et al. 2010

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Gastrointestinal follicular lymphoma (GI-FL) is a relatively rare disease, accounting for only 1%-3.6% of gastrointestinal non-Hodgkin's lymphoma. Although the duodenum and terminal ileum are considered to be the most common sites of origin, the development of wireless capsule endoscopy and double-balloon enteroscopy has increased the detection of GI-FL in every part of the small intestine. Approximately 70% of patients with GI-FL are estimated to have multiple lesions throughout the entire gastrointestinal tract. FL is a low-grade lymphoma that usually develops very slowly. If the lymphoma causes no symptoms, immediate treatment may not be necessary. Standard therapy has not yet been established for GI-FL, but chemotherapy, radiotherapy, monoclonal antibody therapy, or a combination of these therapies, is sometimes performed based on the therapeutic regimens for nodal FL. Regimens including conventional chemotherapy with rituximab, which achieve high response rates in nodal FL, are commonly used for GI-FL. The long-term clinical outcome of GI-FL is unclear. The results of a few series on the long-term outcomes of patients with GI-FL treated with conventional therapy indicate a median relapse-free time ranging from 31 to 45 months. On the other hand, in patients with GI-FL who were followed without treatment, the median time to disease progression was 37.5 months. Thus, whether to initiate aggressive therapy or whether to continue watchful waiting in patients with GI-FL is a critically important decision. Ongoing research on biomarkers to guide individualized GI-FL therapy may provide invaluable information that will lead to the establishment of a standard therapeutic regimen.

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Section: Characteristic Endoscopic Findingsmentioning

confidence: 80%

Section: Characteristic Endoscopic Findingsmentioning

confidence: 99%

Gastrointestinal follicular lymphoma: review of the literature

et al. 2010

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“…In most reported cases of gastrointestinal follicular lymphoma, the eradication of Helicobacter pylori results in unchanged gastric lesions. Moreover, progression of gastric lesions has been observed following successful treatment of Helicobacter pylori (20)(21)(22)(23)(24). Taken together, these findings suggest that the neoplastic follicles of follicular lymphoma are not composed of antigen-driven cells, in contrast to those of MALT lymphoma (20).…”

Section: Discussionmentioning

confidence: 97%

Synchronous Adenocarcinoma and Follicular Lymphoma of the Stomach

et al. 2013

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A 73-year-old Japanese man with synchronous follicular lymphoma and adenocarcinoma of the stomach underwent curative surgical resection. The follicular lymphoma lesion was preoperatively diagnosed as extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) according to biopsy samples. However, postoperative pathological evaluations revealed components of CD10-positive and CD10-negative lymphoma cells within the lymphoma lesion. This case highlights the potential difficulty of diagnosing gastric follicular lymphoma. In such cases, conducting repeat pathological examinations of biopsy samples or resected specimens is required to obtain a correct diagnosis of follicular lymphoma.

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“…It is commonly found in the duodenum, and is a frequent lymphoma in the gastrointestinal tract (1). The clinical course tends to be indolent with a continuous pattern of relapse (2). The median survival is 10 years after diagnosis, though in a recent multicenter, retrospective study male sex and the presence of abdominal symptoms were independently associated with worse clinical outcomes (1).…”

Section: Hallazgo Endoscópico De Linfoma Folicular Primariomentioning

confidence: 99%

Hallazgo endoscópico de linfoma folicular primario

2014

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A 79-year-old female with benign past medical history presented to the gastroenterology clinic complaining of long-standing symptoms of dyspepsia. Esophagogastroduodenoscopy showed nodular smooth mucosa in the second part of the duodenum. The morphologic and immunophenotypic findings were consistent with low-grade follicular lymphoma. The purpose of this manuscript is to educate the reader on this unusual finding that is pathognomonic for gastrointestinal lymphoma.Key words: Lymphoma, duodenum, endoscopy, duodenal diseases, neoplasm. doi: http://dx.doi.org/10.7705/biomedica.v35i1.2291 Hallazgo endoscópico de linfoma folicular primarioUna mujer de 79 años, sin antecedentes patológicos de importancia, consultó al servicio de gastroenterología por síntomas de dispepsia de larga data. Se practicó una esofagogastroduodenoscopia en la que se observó mucosa nodular en la segunda porción del duodeno. Esta morfología y los hallazgos inmunofenotípicos eran indicativos de linfoma folicular de bajo grado. El propósito de este manuscrito es ilustrar al lector sobre esta inusual condición en el duodeno, la cual es patognomónica de linfoma.

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Small Intestinal Follicular Lymphoma with Multiple Tumor Formations Diagnosed by Double-Balloon Enteroscopy

Abstract: Abstract

Cited by 23 publications

References 14 publications

Gastrointestinal follicular lymphoma: review of the literature

Gastrointestinal follicular lymphoma: review of the literature

Synchronous Adenocarcinoma and Follicular Lymphoma of the Stomach

Hallazgo endoscópico de linfoma folicular primario

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