The James Homer Wright Pathology Laboratories, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
Am J Surg Pathol. 2011 Sep;35(9):1255-63. doi: 10.1097/PAS.0b013e318224e661.
Follicular lymphoma (FL), a common nodal lymphoma, is rare in the gastrointestinal (GI) tract. We report our experience with primary FL of the GI tract.
The surgical pathology computer files at the Massachusetts General Hospital were searched for cases of FL involving the GI tract. Patients were included if on staging, the major site of disease was the GI tract. Thirty-nine cases were identified. Clinical data were collected from electronic medical records.
The 27 women and 12 men ranged in age from 29 to 79 years (median, 59 y). Thirty tumors involved the small bowel (19 the duodenum); 8 involved the colon; and 1 involved the stomach. Eight of 10 tumors that were resected involved the small bowel (jejunum and/or ileum without duodenum) of which 5 presented with intestinal obstruction. All tumors were grade 1 or 2. Immunostains showed consistent expression of CD20 (100%), CD10 (97%), and Bcl-2 (97%). Among the 34 cases with Ann Arbor staging information, 22 were stage I, 10 were stage II, and 2 were (6%) stage IV. Of 36 cases with follow-up (median, 4.5 y), 27 patients are alive without disease, 7 are alive with disease, and 2 died of other causes. No lymphoma-related deaths were recorded.
Primary FL of the GI tract occurs most often in middle-aged adults with a 2:1 female preponderance. The most frequent site of involvement is the duodenum, followed by the ileum and colon. Distal small bowel involvement is more likely to present as bowel obstruction requiring resection. The disease is localized in the bowel and regional lymph nodes in the vast majority of cases. The prognosis is favorable even when the disease is disseminated.
滤泡性淋巴瘤（FL）是一种常见的结内淋巴瘤，在胃肠道（GI）中罕见。我们报告了原发性胃肠道 FL 的经验。
马萨诸塞州综合医院的外科病理学计算机文件中搜索了涉及胃肠道的 FL 病例。如果在分期时，主要疾病部位是胃肠道，则纳入患者。确定了 39 例。从电子病历中收集了临床数据。
27 名女性和 12 名男性年龄从 29 岁到 79 岁不等（中位数，59 岁）。30 个肿瘤累及小肠（19 个累及十二指肠）；8 个累及结肠；1 个累及胃。10 个切除的肿瘤中有 8 个累及小肠（空肠和/或回肠无十二指肠），其中 5 个表现为肠梗阻。所有肿瘤均为 1 级或 2 级。免疫组化显示 CD20（100%）、CD10（97%）和 Bcl-2（97%）的表达一致。在具有安阿伯分期信息的 34 例病例中，22 例为 I 期，10 例为 II 期，2 例（6%）为 IV 期。在 36 例有随访的病例中（中位数，4.5 年），27 例患者无病生存，7 例患者有病生存，2 例患者死于其他原因。未记录淋巴瘤相关死亡。
原发性胃肠道 FL 最常发生在中年成人中，女性发病率为 2:1。最常见的受累部位是十二指肠，其次是回肠和结肠。远端小肠受累更可能表现为肠梗阻需要切除。在绝大多数情况下，疾病局限于肠和局部淋巴结。即使疾病扩散，预后也良好。
