Takeuchi Keiko, Iwamuro Masaya, Imagawa Atsushi, Kubota Yoshitsugu, Miyatani Katsuya, Takata Katsuyoshi, Okada Hiroyuki
Department of Gastroenterology, Mitoyo General Hospital, Kan'onji 769-1695, Japan.
Case Rep Med. 2012;2012:582607. doi: 10.1155/2012/582607. Epub 2012 May 29.
A 52-year-old Japanese woman who was eventually diagnosed with primary follicular lymphoma of the duodenum showed atypical endoscopic features, namely, erosions with peripheral whitish edematous mucosa. Initial biopsy specimens taken from the erosions revealed insufficient numbers of lymphoma cells for histological diagnosis. Subsequent biopsy specimens from the peripheral mucosa containing the whitish enlarged villi showed infiltration of the lymphoma cells forming lymphoid follicles, which led us to the appropriate diagnosis. This case indicates that endoscopists should take biopsy samples from the peripheral mucosa with whitish enlarged villi rather than erosions in the rare instances that erosions appear as the main macroscopic feature of intestinal follicular lymphoma.
一名最终被诊断为十二指肠原发性滤泡性淋巴瘤的52岁日本女性表现出非典型的内镜特征，即伴有周边白色水肿黏膜的糜烂。从糜烂处获取的初始活检标本显示，用于组织学诊断的淋巴瘤细胞数量不足。随后从含有白色增大绒毛的周边黏膜获取的活检标本显示，形成淋巴滤泡的淋巴瘤细胞浸润，从而使我们做出了正确的诊断。该病例表明，在内镜检查中，当糜烂作为肠道滤泡性淋巴瘤的主要宏观特征出现的罕见情况下，内镜医师应从伴有白色增大绒毛的周边黏膜而非糜烂处采集活检样本。
