Nakamura Akihiro, Komori Syuichi, Murai So, Shibata Shiori, Oyama Hideyuki, Kijima Kazuhiro, Harada Yoshikuni, Kigawa Gaku, Umemoto Takahiro, Ogawa Takafumi, Tanaka Kuniya
Department of General and Gastroenterological Surgery, Showa Medical University Fujigaoka Hospital, Yokohama, Kanagawa, Japan.
Department of Pathology and Laboratory Medicine, Showa Medical University Fujigaoka Hospital, Yokohama, Kanagawa, Japan.
Surg Case Rep. 2025;11(1). doi: 10.70352/scrj.cr.25-0108. Epub 2025 Jun 18.
Primary gastrointestinal follicular lymphoma (FL) rarely causes intestinal stricture. We report two cases of small intestinal FL presenting with stricture.
Case 1: A 63-year-old man presented with small intestinal obstruction. CT demonstrated ileal wall thickening and enlarged lymph nodes. Partial ileal resection confirmed primary ileal FL, immunohistochemically positive for CD10, CD20, and BCL-2. Case 2: A 79-year-old woman with a 7-year history of jejunal strictures underwent right hemicolectomy for ascending colon cancer and partial jejunal resection. Pathologic examination showed concurrent jejunal FL and colon adenocarcinoma. Immunohistochemical findings were the same as in Case 1. In both patients, postoperative positron-emission tomography-CT showed no residual lymphoma. Both were monitored clinically without chemotherapy.
These cases highlight an unusual presentation of follicular lymphoma as a cause of intestinal stricture. Surgical resection provided diagnostic clarity and relief of symptoms. Postoperative treatment was tailored to individual patient characteristics and residual disease status.
原发性胃肠道滤泡性淋巴瘤（FL）很少引起肠道狭窄。我们报告两例表现为狭窄的小肠FL病例。
病例1：一名63岁男性，表现为小肠梗阻。CT显示回肠壁增厚和淋巴结肿大。部分回肠切除证实为原发性回肠FL，免疫组化CD10、CD20和BCL-2呈阳性。病例2：一名79岁女性，有7年空肠狭窄病史，因升结肠癌行右半结肠切除术及部分空肠切除术。病理检查显示同时存在空肠FL和结肠腺癌。免疫组化结果与病例1相同。两名患者术后正电子发射断层扫描-CT均未显示残留淋巴瘤。两者均未接受化疗，仅进行临床监测。
这些病例突出了滤泡性淋巴瘤作为肠道狭窄原因的一种不寻常表现。手术切除提供了诊断清晰度并缓解了症状。术后治疗根据个体患者特征和残留疾病状态进行调整。
