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Primary follicular lymphoma of the duodenum with erosions as atypical macroscopic features.

Takeuchi K, Iwamuro M, Imagawa A, Kubota Y, Miyatani K, Takata K, Okada H - Case Rep Med (2012)

Bottom Line: A 52-year-old Japanese woman who was eventually diagnosed with primary follicular lymphoma of the duodenum showed atypical endoscopic features, namely, erosions with peripheral whitish edematous mucosa.Subsequent biopsy specimens from the peripheral mucosa containing the whitish enlarged villi showed infiltration of the lymphoma cells forming lymphoid follicles, which led us to the appropriate diagnosis.This case indicates that endoscopists should take biopsy samples from the peripheral mucosa with whitish enlarged villi rather than erosions in the rare instances that erosions appear as the main macroscopic feature of intestinal follicular lymphoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Mitoyo General Hospital, Kan'onji 769-1695, Japan.

ABSTRACT
A 52-year-old Japanese woman who was eventually diagnosed with primary follicular lymphoma of the duodenum showed atypical endoscopic features, namely, erosions with peripheral whitish edematous mucosa. Initial biopsy specimens taken from the erosions revealed insufficient numbers of lymphoma cells for histological diagnosis. Subsequent biopsy specimens from the peripheral mucosa containing the whitish enlarged villi showed infiltration of the lymphoma cells forming lymphoid follicles, which led us to the appropriate diagnosis. This case indicates that endoscopists should take biopsy samples from the peripheral mucosa with whitish enlarged villi rather than erosions in the rare instances that erosions appear as the main macroscopic feature of intestinal follicular lymphoma.

No MeSH data available.


Related in: MedlinePlus

Endoscopic image after local radiation therapy. Both of the duodenal erosions and the whitish mucosa totally disappeared after completion of the radiation therapy. Only a slight deformity of the duodenal mucosa was noted, and this seemed to be a vestige of the lymphoma lesion (arrow). Histological examination confirmed complete remission of the follicular lymphoma.
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fig4: Endoscopic image after local radiation therapy. Both of the duodenal erosions and the whitish mucosa totally disappeared after completion of the radiation therapy. Only a slight deformity of the duodenal mucosa was noted, and this seemed to be a vestige of the lymphoma lesion (arrow). Histological examination confirmed complete remission of the follicular lymphoma.

Mentions: Radiation (40 Gy in 20 fractions) was conducted as a curative therapy for the patient, and the treatment was completed without any adverse events. Esophagogastroduodenoscopy was performed one month after completion of the radiation therapy, and it revealed disappearance of the lymphomatous lesions in the duodenum (Figure 4). Histological evaluation of the biopsied specimens from the duodenal mucosa also confirmed complete remission. The patient remained healthy, with no recurrence of lymphoma for 20 months after the radiation therapy.


Primary follicular lymphoma of the duodenum with erosions as atypical macroscopic features.

Takeuchi K, Iwamuro M, Imagawa A, Kubota Y, Miyatani K, Takata K, Okada H - Case Rep Med (2012)

Endoscopic image after local radiation therapy. Both of the duodenal erosions and the whitish mucosa totally disappeared after completion of the radiation therapy. Only a slight deformity of the duodenal mucosa was noted, and this seemed to be a vestige of the lymphoma lesion (arrow). Histological examination confirmed complete remission of the follicular lymphoma.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3368354&req=5

fig4: Endoscopic image after local radiation therapy. Both of the duodenal erosions and the whitish mucosa totally disappeared after completion of the radiation therapy. Only a slight deformity of the duodenal mucosa was noted, and this seemed to be a vestige of the lymphoma lesion (arrow). Histological examination confirmed complete remission of the follicular lymphoma.
Mentions: Radiation (40 Gy in 20 fractions) was conducted as a curative therapy for the patient, and the treatment was completed without any adverse events. Esophagogastroduodenoscopy was performed one month after completion of the radiation therapy, and it revealed disappearance of the lymphomatous lesions in the duodenum (Figure 4). Histological evaluation of the biopsied specimens from the duodenal mucosa also confirmed complete remission. The patient remained healthy, with no recurrence of lymphoma for 20 months after the radiation therapy.

Bottom Line: A 52-year-old Japanese woman who was eventually diagnosed with primary follicular lymphoma of the duodenum showed atypical endoscopic features, namely, erosions with peripheral whitish edematous mucosa.Subsequent biopsy specimens from the peripheral mucosa containing the whitish enlarged villi showed infiltration of the lymphoma cells forming lymphoid follicles, which led us to the appropriate diagnosis.This case indicates that endoscopists should take biopsy samples from the peripheral mucosa with whitish enlarged villi rather than erosions in the rare instances that erosions appear as the main macroscopic feature of intestinal follicular lymphoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Mitoyo General Hospital, Kan'onji 769-1695, Japan.

ABSTRACT
A 52-year-old Japanese woman who was eventually diagnosed with primary follicular lymphoma of the duodenum showed atypical endoscopic features, namely, erosions with peripheral whitish edematous mucosa. Initial biopsy specimens taken from the erosions revealed insufficient numbers of lymphoma cells for histological diagnosis. Subsequent biopsy specimens from the peripheral mucosa containing the whitish enlarged villi showed infiltration of the lymphoma cells forming lymphoid follicles, which led us to the appropriate diagnosis. This case indicates that endoscopists should take biopsy samples from the peripheral mucosa with whitish enlarged villi rather than erosions in the rare instances that erosions appear as the main macroscopic feature of intestinal follicular lymphoma.

No MeSH data available.


Related in: MedlinePlus