Zhang F, Luo D L, Chen Y, He J, Yan J H, Luo L Q, Luo X L, Liu Y H
Department of Pathology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
Zhonghua Bing Li Xue Za Zhi. 2019 Jan 8;48(1):22-25. doi: 10.3760/cma.j.issn.0529-5807.2019.01.005.
To investigate the clinicopathological features, treatment and prognosis of duodenal-type follicular lymphoma. Four cases of duodenal-type follicular lymphoma diagnosed at Guangdong General Hospital from 2014 to 2015 with detailed clinical data were included. The histomorphology, immunophenotype, treatment and prognoses were analyzed. The patients' age ranged from 51 to 57 years (mean 54 years), and there were 2 males and 2 females. The involved sites were gastric fundus in one case, second portion of the duodenum in two cases and terminal ileum in one case. All patients presented with multiple mucosal granules or nodules at endoscopy. Microscopically, there were multiple mucosal neoplastic follicles, constituting grade 1-2 disease based on nodal follicular lymphoma grading system. The tumor cells were positive for CD20, CD10, bcl-6 and bcl-2. CD21 highlighted the follicular dendritic meshwork mainly at the periphery of the follicles. Proliferation index was low. Three patients received rituximab monotherapy for 4 cycles, leading to complete remission. One patient refused therapy and the disease progressed to systemic lymphoma 15 months after the initial diagnosis. Duodenal-type follicular lymphoma is a special variant of follicular lymphoma with indolent clinical course. The tumor exhibits morphology of low grade follicular lymphoma with characteristic dendritic meshwork at the periphery of the follicles and a low proliferation index. Prognosis is excellent. Rituximab monotherapy is treatment of choice, but a small minority of patients may progress to systemic disease.
探讨十二指肠型滤泡性淋巴瘤的临床病理特征、治疗及预后。纳入2014年至2015年在广东省人民医院确诊的4例十二指肠型滤泡性淋巴瘤患者，其临床资料详细。对其组织形态学、免疫表型、治疗及预后进行分析。患者年龄51至57岁（平均54岁），男2例，女2例。累及部位：胃底1例，十二指肠降部2例，回肠末端1例。所有患者内镜检查均见多发黏膜颗粒或结节。镜下可见多发黏膜肿瘤性滤泡，根据淋巴结滤泡性淋巴瘤分级系统为1 - 2级病变。肿瘤细胞CD20、CD10、bcl - 6及bcl - 2均呈阳性。CD21主要在滤泡周边突出显示滤泡树突状网。增殖指数低。3例患者接受利妥昔单抗单药治疗4个周期，达到完全缓解。1例患者拒绝治疗，初诊后15个月疾病进展为系统性淋巴瘤。十二指肠型滤泡性淋巴瘤是滤泡性淋巴瘤的一种特殊亚型，临床病程惰性。肿瘤表现为低级别滤泡性淋巴瘤形态，滤泡周边有特征性树突状网，增殖指数低。预后良好。利妥昔单抗单药治疗是首选治疗方法，但少数患者可能进展为系统性疾病。
