Iwamuro Masaya, Okada Hiroyuki, Takata Katsuyoshi, Kawai Yoshinari, Kawano Seiji, Nasu Junichiro, Kawahara Yoshiro, Tanaka Takehiro, Yoshino Tadashi, Yamamoto Kazuhide
Department of Molecular Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558,
Acta Med Okayama. 2015;69(1):37-44. doi: 10.18926/AMO/53120.
The sensitivity and specificity of magnified endoscopic features for differentiating follicular lymphoma from other diseases with duodenal whitish lesions have never been investigated. Here we compared the magnified endoscopic features of duodenal follicular lymphoma with those of other whitish lesions. We retrospectively reviewed the cases of patients with follicular lymphoma (n=9), lymphangiectasia (n=7), adenoma (n=10), duodenitis (n=4), erosion (n=1), lymphangioma (n=1), and hyperplastic polyp (n=1). The magnified features of the nine follicular lymphomas included enlarged villi (n=8), dilated microvessels (n=5), and opaque white spots of various sizes (n=9). The lymphangiectasias showed enlarged villi, dilated microvessels, and white spots, but the sizes of the white spots were relatively homogeneous and their margin was clear. Observation of the adenoma and duodenitis revealed only whitish villi. Although the lymphangioma was indistinguishable from the follicular lymphomas by magnified features, it was easily diagnosed based on the macroscopic morphology. In conclusion, magnified endoscopic features, in combination with macroscopic features, are useful for differentiating follicular lymphomas from other duodenal diseases presenting whitish lesions.
放大内镜特征在鉴别十二指肠滤泡性淋巴瘤与其他伴有十二指肠白色病变疾病中的敏感性和特异性从未被研究过。在此,我们比较了十二指肠滤泡性淋巴瘤与其他白色病变的放大内镜特征。我们回顾性分析了滤泡性淋巴瘤患者(n=9)、淋巴管扩张症患者(n=7)、腺瘤患者(n=10)、十二指肠炎患者(n=4)、糜烂患者(n=1)、淋巴管瘤患者(n=1)和增生性息肉患者(n=1)的病例。9例滤泡性淋巴瘤的放大特征包括绒毛增大(n=8)、微血管扩张(n=5)和大小不一的不透明白色斑点(n=9)。淋巴管扩张症表现为绒毛增大、微血管扩张和白色斑点,但白色斑点大小相对均匀且边缘清晰。腺瘤和十二指肠炎的观察仅显示白色绒毛。尽管淋巴管瘤通过放大特征与滤泡性淋巴瘤难以区分,但基于宏观形态很容易诊断。总之,放大内镜特征结合宏观特征有助于鉴别滤泡性淋巴瘤与其他呈现白色病变的十二指肠疾病。