Takamura Masaaki, Narisawa Rintaro, Maruyama Yudzuru, Yokoyama Junji, Fukuhara Yasuo, Kawai Hirokazu, Yamagiwa Satoshi, Sato Yuichi, Matsuda Yasunobu, Sugimura Kazuhito, Ichida Takafumi, Aoyagi Yutaka
Department of Gastroenterology and Hepatology, Niigata University, Graduate School of Medical and Dental Sciences, Asahimachi-dori.
Intern Med. 2006;45(5):309-11. doi: 10.2169/internalmedicine.45.1464. Epub 2006 Apr 3.
A 48-year-old man was admitted to our hospital because of repeated episodes of epigastralgia. Endoscopy showed multiple whitish granules extending from the 2nd to 3rd portion of the duodenum. Biopsy specimens showed well circumscribed follicles with a monotonous population of predominantly small cleaved cells that were positive for CD20, CD10 and BCL2, but negative for CD5. A full staging study showed no abnormalities. The tumor was finally diagnosed according to the WHO classification as a stage I follicular lymphoma (FL), grade 1, of the duodenum and subsequently received irradiation to the involved area. After 3 years of followup, he is still in complete remission. Because FL arising in the duodenum has recently reported with increasing frequency, patients with multiple granules in the duodenum should be examined carefully.
一名48岁男性因反复上腹部疼痛入院。内镜检查显示十二指肠第二至第三段有多个白色颗粒。活检标本显示边界清楚的滤泡，主要为小裂细胞，细胞形态单一，CD20、CD10和BCL2阳性，但CD5阴性。全面分期检查未发现异常。根据世界卫生组织分类，该肿瘤最终被诊断为十二指肠I期1级滤泡性淋巴瘤（FL），随后对受累区域进行了放疗。经过3年的随访，他仍处于完全缓解状态。由于十二指肠发生的FL最近报道的频率越来越高，十二指肠有多个颗粒的患者应仔细检查。
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