A Resected Case of the Follicular Lymphoma of the Duodenum

Ichiro Akiyama, Ryuji Hirai, Masakazu Murakami, Tethuya Ohta, Hiroyoshi Doihara, Akio Andou and Nobuyoshi Shimizu

Department of Surgery II, Okayama University School of Medicine

A 69-year-man admitted for bloody feces was found in endoscopy to have a giant irregular elevated lesion in the second portion of the duodenum. Histological study of a biopsy specimen showed B cell lymphoma. The patient underwent PpPD with no evidence of distant metastasis by computed tomograpy (CT) and gallium scintigraphy. The tumor in the resected specimen involved a length of the duodenum 5.2 cm from the anal side of the ampulla of Vater. There were 2 positive periduodenal nodes and direct invasion through the pancreas. Postoperative diagnosis was stage IIE, modified Musshoff classification. Histological findings of the tumor showed follicular lymphoma, Grade 1. We did not attempt adjuvant therapy. The optimum management of primary duodenal lymphomas is still controversial because this tumor is extremely rare. It is important to clarify therapeutic benefit and prognosis in sufficient numbers of patients based on the new World Health Organization classification.

Key words
malignant lymphoma of the duodenum, follicular lymphoma, pyrorus preserving pancreaticoduodenectomy

Reprint requests
Ichiro Akiyama Department of Surgery II, Okayama University School of Medicine 2-5-1 Shikata-cho, Okayama, 700-8558 JAPAN

Accepted
May 29, 2002

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