From the Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York.
Arch Pathol Lab Med. 2018 Apr;142(4):542-547. doi: 10.5858/arpa.2016-0519-RS.
Duodenal-type follicular lymphoma (D-FL) is a newly recognized entity in the 2016 World Health Organization classification update. It has an immunophenotype similar to that of other FLs and usually carries the typical t(14;18)(q32;q21) translocation. However, unlike other FLs, D-FL is almost always diagnosed at a low stage and stays localized to the small intestine, most commonly the second portion of the duodenum, whereas the vast majority of other FLs are diagnosed at an advanced stage. Additionally, D-FL gene expression and pathogenesis appear to be more closely related to extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue than to other types of FL. Therefore, many oncologists have opted to treat this variant of FL in a "watch and wait" manner because of its excellent prognosis and the rarity of D-FL to progress even when no treatments are attempted.
十二指肠型滤泡淋巴瘤（D-FL）是 2016 年世界卫生组织分类更新中新认定的一种疾病。它具有与其他滤泡性淋巴瘤相似的免疫表型，通常携带典型的 t(14;18)(q32;q21)易位。然而，与其他滤泡性淋巴瘤不同的是，D-FL 几乎总是在低期诊断，且局限于小肠，最常见于十二指肠的第二段，而绝大多数其他滤泡性淋巴瘤则在晚期诊断。此外，D-FL 的基因表达和发病机制似乎与黏膜相关淋巴组织结外边缘区淋巴瘤更为密切相关，而与其他类型的滤泡性淋巴瘤关系不大。因此，许多肿瘤学家选择以“观察和等待”的方式治疗这种滤泡性淋巴瘤的变体，因为它的预后极好，而且即使不进行治疗，D-FL 进展的情况也极为罕见。
