Maeshima Akiko Miyagi, Taniguchi Hirokazu, Suzuki Tomotaka, Yuda Sayako, Toyoda Kosuke, Yamauchi Nobuhiko, Makita Shinichi, Fukuhara Suguru, Munakata Wataru, Maruyama Dai, Kobayashi Yukio, Saito Yutaka, Tobinai Kensei
Pathology Division, National Cancer Center Hospital, Tokyo 104-0045, Japan.
Pathology Division, National Cancer Center Hospital, Tokyo 104-0045, Japan.
Hum Pathol. 2017 Jul;65:201-208. doi: 10.1016/j.humpath.2017.04.025. Epub 2017 May 10.
We compared the incidence, esophagogastroduodenoscopy (EGD) findings, and histopathologic characteristics of gastric and duodenal follicular lymphomas (FL). Of 626 FL cases, primary gastric FL and secondary gastric involvement of FL were observed in 1% and 5% of the cases, respectively, which were lower incidences than duodenal FL (10% and 9%, respectively). Gastric FL usually appeared as submucosal tumors (primary, 71%; secondary, 79%), whereas duodenal FL, as granular lesions (primary, 92%: secondary, 87%). In the granular duodenal lesions, the neoplastic follicles were located sparsely on the muscularis mucosa and could be found between villi, whereas in the stomach, similar lesions were hidden within the lamina propria, and only larger lesions such as submucosal tumors could be detected on the mucosal surface. The differences in the incidences and EGD findings were considered to be associated with structural differences of the lamina propria. Typical FL features: grades 1-2 histology, follicularity, and CD10 and/or BCL6 and BCL2 were usually observed in all primary and secondary gastric and duodenal FL. Gastroduodenal and bone marrow involvement were found in 12% and 33% of the cases, respectively, and there was no significant correlation between them (P=.095). Twenty-nine cases (5%) were up-staged by gastroduodenal-positive results. In conclusion, the histopathology of gastric FL was similar to that of duodenal and nodal FL; the differences in the incidence and EGD findings between gastric and duodenal FL were considered to be associated with structural difference of the lamina propria, and EGD was useful as a staging procedure.
我们比较了胃和十二指肠滤泡性淋巴瘤（FL）的发病率、食管胃十二指肠镜检查（EGD）结果以及组织病理学特征。在626例FL病例中，原发性胃FL和FL的继发性胃受累分别在1%和5%的病例中观察到，其发病率低于十二指肠FL（分别为10%和9%）。胃FL通常表现为黏膜下肿瘤（原发性，71%；继发性，79%），而十二指肠FL表现为颗粒状病变（原发性，92%；继发性，87%）。在十二指肠颗粒状病变中，肿瘤性滤泡稀疏地位于黏膜肌层，可在绒毛之间发现，而在胃中，类似病变隐藏在固有层内，只有较大的病变如黏膜下肿瘤才能在黏膜表面检测到。发病率和EGD结果的差异被认为与固有层的结构差异有关。典型的FL特征：1-2级组织学、滤泡性以及CD10和/或BCL6和BCL2通常在所有原发性和继发性胃及十二指肠FL中观察到。胃十二指肠和骨髓受累分别在12%和33%的病例中发现，且两者之间无显著相关性（P = 0.095）。29例（5%）因胃十二指肠阳性结果而上调分期。总之，胃FL的组织病理学与十二指肠和淋巴结FL相似；胃和十二指肠FL在发病率和EGD结果上的差异被认为与固有层的结构差异有关，且EGD作为一种分期检查方法是有用的。
