Abstract
A 67-year-old man was referred to our hospital for treatment of gastrointestinal follicular lymphoma (FL) in 2009. He had been treated with methotrexate for rheumatoid arthritis (RA) since 2000. Methotrexate was changed to salazosulfapyridine because of his FL. He was treated with rituximab monotherapy against FL and achieved complete remission. In 2014, a follow-up esophagogastroduodenoscopy (EGD) showed recurrent FL in his duodenum. The FL increased gradually until January 2018 (Fig. 1A). Pathologically, neoplastic lymphocytes had a follicular pattern (Fig.
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