Charoenlap Cheep, Akarapatima Keerati, Suwanno Komsai, Rattanasupar Attapon, Chang Arunchai
Department of Anatomical Pathology, Hatyai Hospital, Songkhla, Thailand.
Division of Gastroenterology, Department of Internal Medicine, Hatyai Hospital, Songkhla, Thailand.
Gastroenterol Hepatol Bed Bench. 2021 Spring;14(2):185-189.
Follicular lymphoma (FL) is one of the most common types of non-Hodgkin lymphoma (NHL). The gastrointestinal tract is the most involved extra-nodal site of NHL. Primary duodenal FL (DFL) is a rare entity with only a few reported cases. It mainly involves the second part of the duodenum and has an excellent prognosis. We report the case of a 74-year-old man who underwent esophagogastroduodenoscopy. Endoscopic findings revealed multiple small whitish mucosal nodules which were detected around the major duodenal papilla. Biopsy of these lesions was compatible with grade I FL. Further investigation failed to demonstrate any evidence of nodal or systemic involvement; thus, the clinical staging was stage I, according to the Lugano staging system. A "watch and wait" policy was chosen. Neither lesion aggregation nor lymphadenopathy was noted during the 5-year follow-up period. In conclusion, this was an uncommon case of DFL with an indolent nature and excellent prognosis. However, further studies are needed to clarify the characteristics, prognosis, and therapeutic approach.
滤泡性淋巴瘤（FL）是最常见的非霍奇金淋巴瘤（NHL）类型之一。胃肠道是NHL最常累及的结外部位。原发性十二指肠FL（DFL）是一种罕见的疾病，仅有少数病例报道。它主要累及十二指肠第二部，预后良好。我们报告一例74岁男性接受食管胃十二指肠镜检查的病例。内镜检查发现十二指肠乳头周围有多个小的白色黏膜结节。这些病变的活检结果符合I级FL。进一步检查未发现任何淋巴结或全身受累的证据；因此，根据卢加诺分期系统，临床分期为I期。我们选择了“观察等待”策略。在5年随访期间，未发现病变聚集或淋巴结肿大。总之，这是一例罕见的DFL病例，具有惰性病程和良好的预后。然而，需要进一步研究以阐明其特征、预后和治疗方法。
