A Case of Primary Follicular Lymphoma of the Duodenum

Kazuhito Oka, Hiroaki Takenaka, Atsushi Suga, Masahiko Orita, Nobuyoshi Morita and Kimikazu Hamano*

Department of Surgery, Hikari Municipal Hikari General Hospital
Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine*

We report a case of primary follicular lymphoma of the duodenum with an unusual macroscopic lesion. A 62-year-old-woman admitted for epigastric pain had undergone direct hemostasis for a hemorrhagic duodenal ulcer 7 years earlier, and had been followed up regularly. Upper gastroendoscopic examination upon admission showed multiple elevated lesions covered with slightly whitish mucosa at the ampulla of Vater and, on the anal side, thickened folds with a waffle-like appearance. Biopsy indicated follicular lymphoma. Because no findings suggested other organ or mediastinum/celiac lymph node metastasis, we believed the duodenum to be the primary organ. After subtotal stomach-preserving pancreaticoduodenectomy, histopathological analysis showed lymph nodes 13 and 17 to be positive. The disease stage was II1E based on the Ann Arbor system and IIunder Naqvi classification. Because of curative resection and the early stage, she did not undergo chemotherapy or other postoperative treatment and after 7 months of follow-up shows no evidence of recurrence.

Key words
follicular lymphoma, duodenum, malignant lymphoma

Reprint requests
Kazuhito Oka Department of Surgery, Hikari Municipal Hikari General Hospital
10-1 Nijigahama, Hikari, 743-0022 JAPAN

Accepted
March 28, 2007

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