Primary Duodenal Follicular Lymphoma Research Articles

Primary follicular lymphoma of the duodenum: a case report and review of literatures

Follicular lymphoma (FL) is one of the most common types of non-Hodgkin lymphoma (NHL). The gastrointestinal tract is the most involved extra-nodal site of NHL. Primary duodenal FL (DFL) is a rare entity with only a few reported cases. It mainly involves the second part of the duodenum and has an excellent prognosis. We report the case of a 74-year-old man who underwent esophagogastroduodenoscopy. Endoscopic findings revealed multiple small whitish mucosal nodules which were detected around the major duodenal papilla. Biopsy of these lesions was compatible with grade I FL. Further investigation failed to demonstrate any evidence of nodal or systemic involvement; thus, the clinical staging was stage I, according to the Lugano staging system. A "watch and wait" policy was chosen. Neither lesion aggregation nor lymphadenopathy was noted during the 5-year follow-up period. In conclusion, this was an uncommon case of DFL with an indolent nature and excellent prognosis. However, further studies are needed to clarify the characteristics, prognosis, and therapeutic approach.

Primary duodenal follicular lymphoma with late disseminated nodal relapse responsive to rituximab monotherapy: A case report.

Gastrointestinal follicular lymphoma is a rare malignancy accounting for only 1-3.6% of primary non-Hodgkin lymphomas of the gastrointestinal tract and it is a relatively new clinical entity that was recently classified as a distinct variant of systemic follicular lymphoma. Therefore, data regarding long-term outcome are currently lacking. In addition, a consensus on the management of this disease has not been established and treatment strategies are derived from systemic follicular lymphoma. We herein report the case of a 51-year-old female patient diagnosed with duodenal follicular lymphoma who had nodal relapse nearly 5 years after complete remission. The patient was successfully treated with a 4-week course of rituximab during the initial diagnosis and relapse. To the best of our knowledge, this is the first case report to demonstrate the efficacy of a 4-week course of rituximab during both the initial diagnosis and nodal relapse. The aim of this report was to add to the limited available data on the treatment of gastrointestinal follicular lymphoma.

Primary duodenal follicular lymphoma: a case report

<h3>Background</h3> Follicular lymphoma (FL) is a predominantly nodal disease and extranodal involvement can be seen in widespread nodal disease. Primary extra-nodal FLs are, however, reported in skin, ocular adenexa, Waldeyer's ring and intestine where the majority are mucosa-associated-lymphoid-tissue (MALT) lymphoma and diffuse large B-cell lymphoma. Primary duodenal follicular lymphoma (FL-D) is a distinct mucosal/submucosal variant of FL. <h3>Case presentation</h3> A 44-year-old man presented with vomiting and subsequent endoscopic examination revealed small bubbly appearances in the first part of the duodenum. Three superficial duodenal mucosal biopsies showed preservation of the normal villous architecture; however, there was a prominent lymphoid infiltrate with prominent follicle formation within the lamina propria of the villi. Whilst CD3/CD5 positive T lymphocytes were present, the majority of the lymphoid cells, and the lymphoid cells forming the lymphoid follicles were positive for CD20, bcl2, bcl6 and CD10 and negative for cyclinD1; CD21 highlighted the follicular dendritic networks. Only very occasional centroblasts were noted within the lymphoid follicles, consistent with Grade-1 FL. <h3>Disscussion</h3> FL-D, first described in 1997, is a rare disease accounting for 1–3.6% of primary GIT lymphomas. FL-Ds are typically low grade. Transformation to high grade disease or systemic dissemination appears extremely uncommon.

十二指腸原発濾胞性リンパ腫の1例

十二指腸原発濾胞性リンパ腫の1例

Magnified endoscopic observation with Fuji Intelligent Chromo Endoscopy of primary duodenal follicular lymphoma

Follicular lymphoma occurs rarely in the gastrointestinal tract, comprising only 1 % – 3 % of all B-cell non-Hodgkin lymphomas of the gastrointestinal tract [1]. Prior reports have described cases of follicular lymphoma by using advanced endoscopic imaging [1] [2] [3] [4]. With narrow-band imaging (NBI) and magnification, follicular lymphoma is reported to show as enhanced whitish areas within enlarged villi and with a coiled vascular pattern [1] [2]. According to a previous case report [1], the lesion was also identified as whitish small nodules in the jejunum by using Fuji Intelligent Chromo Endoscopy (FICE). However, FICE in combination with magnified endoscopy in follicular lymphoma has not been reported to date.

The indolent course and high incidence of t(14;18) in primary duodenal follicular lymphoma

BackgroundInformation on the clinical behavior of the recently proposed primary duodenal follicular lymphoma (DFL) is limited. Patients and methodsDemographic data, signs, symptoms, disease stage, and treatment of the patients diagnosed in National Cancer Center Hospital from 1999 to 2007 were collected and analyzed. ResultsTwenty-seven patients were studied. Nineteen patients were asymptomatic at the time of diagnosis. Twenty patients had stage I disease. The histological grade was 1 or 2 in 26 patients. IgH/BCL2 fusion was shown in 20 of the examined 24 cases (83%). Fourteen patients received therapy upon diagnosis (local radiotherapy in 2 patients and chemotherapy in 12 including rituximab therapy), their response rate was 85%, and the estimated progression-free survival (PFS) rate at 3 years was 70%. One patient developed histological transformation. The other 13 patients were followed up; their estimated PFS rate at 3 years was 74%. Five among six cases responded to treatment even after progressive disease. All 27 patients have survived with a median follow-up time of 47.9 months. ConclusionsThe majority of primary DFL patients have a localized tumor of low-grade histology and are positive for t(14;18). Watchful waiting might be an alternative approach for its indolent course; however, further studies are warranted.

Clinical and molecular complete remission of primary duodenal follicular lymphoma following treatment with rituximab and cyclophosphamide, vincristine and prednisone chemotherapy

Internal Medicine JournalVolume 39, Issue 10 p. 706-707 Clinical and molecular complete remission of primary duodenal follicular lymphoma following treatment with rituximab and cyclophosphamide, vincristine and prednisone chemotherapy S. Falorio, S. Falorio Department of Hematology, Civic Hospital, Fonteromana, Pescara, ItalySearch for more papers by this authorF. Angrilli, F. Angrilli Department of Hematology, Civic Hospital, Fonteromana, Pescara, ItalySearch for more papers by this authorG. Fioritoni, G. Fioritoni Department of Hematology, Civic Hospital, Fonteromana, Pescara, ItalySearch for more papers by this author S. Falorio, S. Falorio Department of Hematology, Civic Hospital, Fonteromana, Pescara, ItalySearch for more papers by this authorF. Angrilli, F. Angrilli Department of Hematology, Civic Hospital, Fonteromana, Pescara, ItalySearch for more papers by this authorG. Fioritoni, G. Fioritoni Department of Hematology, Civic Hospital, Fonteromana, Pescara, ItalySearch for more papers by this author First published: 14 October 2009 https://doi.org/10.1111/j.1445-5994.2009.02027.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume39, Issue10October 2009Pages 706-707 RelatedInformation

Impact of double-balloon endoscopy on the diagnosis of jejunoileal involvement in primary intestinal follicular lymphomas: a case series

In recent years, primary gastrointestinal follicular lymphoma has been increasingly detected in the duodenum on esophagogastroduodenoscopy (EGD). Primary gastrointestinal follicular lymphomas are frequently distributed to multiple sites in the gastrointestinal tract. Therefore, investigation into the spread of follicular lymphomas in the small bowel is important in order to determine the most appropriate treatment strategy. The performance of double-balloon endoscopy (DBE) in the diagnosis of jejunoileal follicular lymphoma lesions has not been fully evaluated. We aimed to investigate the value of DBE in addition to computed tomography (CT) and (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG-PET) in the diagnosis of jejunoileal follicular lymphoma. DBE with biopsy was performed in seven patients with primary duodenal follicular lymphoma diagnosed by EGD, in order to investigate jejunoileal involvement. Jejunoileal follicular lymphoma lesions were detected by DBE in six out of the seven patients (three in the jejunum and three in the jejunum and ileum), whereas CT and (18)F-FDG-PET failed to detect the existence of these lesions. Endoscopic findings of the jejunoileal lesions revealed multiple white nodules and white villi, which were similar to those of duodenal lesions. DBE was more useful for the diagnosis of jejunoileal involvement in primary intestinal follicular lymphoma than CT and (18)F-FDG-PET. The use of DBE will become important for determining the most appropriate treatment for gastrointestinal follicular lymphoma.

Primary duodenal follicular lymphoma successfully treated with rituximab

Non-Hodgkin's lymphoma (NHL) of the gastrointestinal (GI) tract is the most common extranodal lymphoma, accounting for approximately 40% of all extranodal NHLs. Initial treatment of duodenal lymphoma includes surgery, chemotherapy and radiotherapy, alone or in combination. Here, we present a case of stage I primary duodenal follicular lymphoma (FL) showing a complete response after rituximab therapy. Rituximab alone can be an effective alternative treatment for duodenal FL.