Kunieda Yasuyuki, Matsuoka Satomi, Kikuchi Misato, Kawamura Naoki, Tanaka Shinya
Department of Internal Medicine, Wakkanai City Hospital.
Rinsho Ketsueki. 2014 Dec;55(12):2408-13. doi: 10.11406/rinketsu.55.2408.
A 79-year-old man received gastrointestinal endoscopy for reexamination of a gastric submucosal tumor in May 2002 and whitish granular mucosa was found near the ampulla of Vater of the duodenum, though biopsy specimens showed only lymphocyte infiltrations. In December 2002, a second gastrointestinal endoscopy revealed an irregular granular elevated lesion around the ampulla of Vater and biopsy specimens showed pathological findings of follicular lymphoma. No other abnormal findings raising suspicion of tumor formation were observed on systemic examinations and the diagnosis of duodenal follicular lymphoma was confirmed. Systemic chemotherapy using rituximab at 375 mg/m(2) weekly for 4 consecutive weeks was started in January 2003. Six months later, endoscopic findings of the lesions revealed nearly normal mucosa around the ampulla of Vater, though histologically the biopsy specimens showed residual lymphoma cells. The same rituximab therapy as before was started in November. There has been no evidence of recurrence and a prolonged, more than 10 years, complete remission has been achieved.
一名79岁男性于2002年5月接受胃肠内镜检查以复查胃黏膜下肿瘤，在十二指肠乳头附近发现白色颗粒状黏膜，尽管活检标本仅显示淋巴细胞浸润。2002年12月，第二次胃肠内镜检查显示十二指肠乳头周围有不规则颗粒状隆起病变，活检标本显示为滤泡性淋巴瘤的病理结果。全身检查未发现其他提示肿瘤形成的异常发现，十二指肠滤泡性淋巴瘤的诊断得以确诊。2003年1月开始使用利妥昔单抗进行全身化疗，剂量为375 mg/m²，每周1次，连续4周。6个月后，病变的内镜检查结果显示十二指肠乳头周围黏膜几乎正常，尽管组织学上活检标本显示仍有残留淋巴瘤细胞。11月开始再次使用与之前相同的利妥昔单抗治疗。目前尚无复发证据，已实现超过10年的长期完全缓解。
