Primary follicular lymphoma of the gastrointestinal tract: a retrospective case series

Little is known about the clinicopathologic characteristics of primary follicular lymphoma of the gastrointestinal tract (PFLGI). We report our experience with double-balloon enteroscopy (DBE) in patients with PFLGI. Between January 2001 and December 2006, thirteen patients with PFLGI (nine men and four women; mean age, 53.4 years) visited Hiroshima University Hospital. We performed DBE in 11 PFLGI patients to examine the entire small bowel. DBE showed new lesions in the third portion of the duodenum, jejunum, or ileum in nine of these 11 patients (81.8 %). The endoscopic finding was nodularity of the involved mucosal surface (small whitish polyps or whitish granules). Seven patients were treated with rituximab plus CHOP chemotherapy (R-CHOP). A complete response was obtained in all patients who received R-CHOP, and no recurrence was seen (mean follow-up period, 22.5 months).

References

• 1 Cirillo M, Federico M, Curci G. et al . Primary gastrointestinal lymphoma: a clinicopathological study of 58 cases.  Haematologica. 1992;  77 156-161
• 2 Yoshino T, Miyake K, Ichimura K. et al . Increased incidence of follicular lymphoma in the duodenum.  Am J Surg Pathol. 2000;  24 688-693
• 3 Otter R, Bieger R, Kluin P M. et al . Primary gastrointestinal non-Hodgkin’s lymphoma in a population-based registry.  Br J Cancer. 1989;  60 745-750
• 4 Contreary K, Nance F C, Becker W F. Primary lymphoma of the gastrointestinal tract.  Ann Surg. 1980;  191 593-598
• 5 Costamagna G, Shah S K, Riccioni M E. et al . A prospective trial comparing small bowel radiographs and video capsule endoscopy for suspected small bowel disease.  Gastroenterology. 2002;  123 999-1005
• 6 Ell C, Remke S, May A. et al . The first prospective controlled trial comparing wireless capsule endoscopy with push enteroscopy in chronic gastrointestinal bleeding.  Endoscopy. 2002;  34 685-689
• 7 Faigel D O, Fennerty M B. ”Cutting the cord” for capsule endoscopy.  Gastroenterology. 2002;  123 1385-1388
• 8 Yamamoto H, Sekine Y, Sato Y. et al . Total enteroscopy with a nonsurgical steerable double-balloon method.  Gastrointest Endosc. 2001;  53 216-220
• 9 Yamamoto H, Yano T, Kita H. et al . New system of double-balloon enteroscopy for diagnosis and treatment of small intestinal disorders.  Gastroenterology. 2003;  125 1556; author reply 1556-1557
• 10 Harris N L, Jaffe E S, Diebold J. et al . The World Health Organization classification of neoplastic diseases of the haematopoietic and lymphoid tissues: Report of the Clinical Advisory Committee Meeting, Airlie House, Virginia, November 1997.  Histopathology. 2000;  36 69-86
• 11 Rohatiner A, d’Amore F, Coiffier B. et al . Report on a workshop convened to discuss the pathological and staging classifications of gastrointestinal tract lymphoma.  Ann Oncol. 1994;  5 397-400
• 12 LeBrun D P, Kamel O W, Cleary M L. et al . Follicular lymphomas of the gastrointestinal tract. Pathologic features in 31 cases and bcl-2 oncogenic protein expression.  Am J Pathol. 1992;  140 1327-1335
• 13 Shia J, Teruya-Feldstein J, Pan D. et al . Primary follicular lymphoma of the gastrointestinal tract: a clinical and pathologic study of 26 cases.  Am J Surg Pathol. 2002;  26 216-224
• 14 Damaj G, Verkarre V, Delmer A. et al . Primary follicular lymphoma of the gastrointestinal tract: a study of 25 cases and a literature review.  Ann Oncol. 2003;  14 623-629
• 15 Harris N L, Jaffe E S, Stein H. et al . Lymphoma classification proposal: clarification.  Blood. 1995;  85 857-860
• 16 Anderson K C, Bates M P, Slaughenhoupt B L. et al . Expression of human B cell-associated antigens on leukemias and lymphomas: a model of human B cell differentiation.  Blood. 1984;  63 1424-1433
• 17 Czuczman M S, Weaver R, Alkuzweny B. et al . Prolonged clinical and molecular remission in patients with low-grade or follicular non-Hodgkin’s lymphoma treated with rituximab plus CHOP chemotherapy: 9-year follow-up.  J Clin Oncol. 2004;  22 4711-4716