Sato Y, Ichimura K, Tanaka T, Takata K, Morito T, Sato H, Kondo E, Yanai H, Ohara N, Oka T, Yoshino T
Department of Pathology, Okayama University Graduate School of Medical, Dentistry and Pharmaceutical Sciencies, Okayama, Japan.
J Clin Pathol. 2008 Mar;61(3):377-81. doi: 10.1136/jcp.2007.049825. Epub 2007 Jun 29.
Follicular lymphomas occasionally arise in the extra-nodal organs and are frequently found in the duodenum. They are often localised tumours with multiple polyps around the ampulla of Vater.
To examine a IgH/bcl-2 hybrid gene and VH gene to investigate the nature of the lymphoma cells and how they differ from nodal follicular lymphomas and MALT lymphomas.
Of 40 patients reported previously, 35 with duodenal follicular lymphoma were studied in detail with respect to clinicopathological characteristics.
37/40 patients were in clinical stage I (n = 30) or stage II (n = 7). Clonal immunoglobulin gene rearrangement was detected in 53.3% of examined cases, and rearrangement of IgH/bcl-2 gene at the major break point was detected in 27% of cases. Three of 8 examined cases were VH4 (38%); 2 out of them were VH4-34. As VH4 deviation is one of the common characteristics of MALT lymphomas and 2/3 were identical, duodenal follicular lymphomas have a similar aetiology to MALT lymphomas. Clinical course was also similar to that of MALT lymphomas.
Results suggest that duodenal follicular lymphomas have intermediate characteristics of MALT lymphomas and nodal follicular lymphomas.
滤泡性淋巴瘤偶尔发生于结外器官，常见于十二指肠。它们通常是局限性肿瘤，在 Vater 壶腹周围有多个息肉。
检测 IgH/bcl-2 杂交基因和 VH 基因，以研究淋巴瘤细胞的性质以及它们与结内滤泡性淋巴瘤和黏膜相关淋巴组织淋巴瘤的差异。
在先前报告的 40 例患者中，对 35 例十二指肠滤泡性淋巴瘤患者的临床病理特征进行了详细研究。
40 例患者中 37 例处于临床 I 期（n = 30）或 II 期（n = 7）。在 53.3%的检测病例中检测到克隆性免疫球蛋白基因重排，在 27%的病例中检测到 IgH/bcl-2 基因在主要断裂点的重排。8 例检测病例中有 3 例为 VH4（38%）；其中 2 例为 VH4-34。由于 VH4 偏移是黏膜相关淋巴组织淋巴瘤的常见特征之一，且 2/3 相同，十二指肠滤泡性淋巴瘤与黏膜相关淋巴组织淋巴瘤有相似的病因。临床病程也与黏膜相关淋巴组织淋巴瘤相似。
结果表明十二指肠滤泡性淋巴瘤具有黏膜相关淋巴组织淋巴瘤和结内滤泡性淋巴瘤的中间特征。
