Tsujioka Takayuki, Wada Hideho, Yata Ken-ichiro, Kondo Toshinori, Suemori Sinichiro, Tokunaga Hirotoshi, Ohmori Konosuke, Kubo Yasutaka, Nakanishi Hidekazu, Mikami Makoto, Haruma Ken, Sadahira Yoshito, Sugihara Takashi
Division of Hematology, Department of Medicine, Kawasaki Medical School.
Rinsho Ketsueki. 2007 Feb;48(2):134-9.
We performed a clinical analysis on 8 patients with primary follicular lymphoma in the duodenum taken from among 26 cases of primary gastrointestinal malignant lymphoma treated in our division. The median age was 60 years (range 48 to 82 yr). The ratio of males to females was 4:4. The chief complaints were no symptoms in 4 cases, heartburn in 2 cases, lower abdominal pain in 1 case, and back pain in 1 case. All patients were in clinical stage I EA. Gastroendoscopic findings showed multiple whitish granules around the ampulla of Vater in all patients. Involvement of the site in 6 cases was only located at the second portion; lesions in the other 2 cases were located at the second portion, and at the third portion or fourth portion, respectively. A histological study showed follicular lymphoma grade 1, and an immunohistological study demonstrated that the lymphoma cells were positive for CD79a, CD10, CD20, and bcl-2. Five patients were positive for the FISH analysis fusion signal of IgH/bcl-2 genes. Rituximab with CHOP therapy was performed for 7 patients. Seven patients are currently alive, and one died of uterine cancer. At the medium-term 39 month-follow-up, 7 patients were in complete remission, and 1 patient was in partial remission. Rituximab with CHOP (CVP) therapy is a possible treatment for primary follicular lymphoma in the duodenum. Further consideration of appropriate therapy for this disease might be necessary.
我们对从本科室收治的26例原发性胃肠道恶性淋巴瘤患者中选取的8例十二指肠原发性滤泡性淋巴瘤患者进行了临床分析。中位年龄为60岁（范围48至82岁）。男女比例为4:4。主要症状方面，4例无症状，2例有烧心症状，1例有下腹痛，1例有背痛。所有患者均处于临床I期EA。胃镜检查结果显示，所有患者在 Vater壶腹周围均有多个白色颗粒。6例患者的病变仅位于十二指肠第二部；另外2例患者的病变分别位于第二部、第三部或第四部。组织学研究显示为1级滤泡性淋巴瘤，免疫组织学研究表明淋巴瘤细胞CD79a、CD10、CD20和bcl-2呈阳性。5例患者的FISH分析显示IgH/bcl-2基因融合信号呈阳性。7例患者接受了利妥昔单抗联合CHOP治疗。目前7例患者存活，1例死于子宫癌。在39个月的中期随访中，7例患者完全缓解，1例患者部分缓解。利妥昔单抗联合CHOP（CVP）治疗可能是十二指肠原发性滤泡性淋巴瘤的一种治疗方法。可能有必要进一步考虑针对该疾病的适当治疗方法。
