Iwamuro M, Kawai Y, Takata K, Kawano S, Yoshino T, Okada H, Yamamoto K. Primary intestinal follicular lymphoma: How to identify follicular lymphoma by routine endoscopy. World J Gastrointest Endosc 2013; 5(1): 34-38 [PMID: 23330052 DOI: 10.4253/wjge.v5.i1.34]
Corresponding Author of This Article
Dr. Masaya Iwamuro, Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-Ku, Okayama 700-8558, Japan. iwamuromasaya@yahoo.co.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Masaya Iwamuro, Yoshinari Kawai, Department of Gastroenterology, Onomichi Municipal Hospital, Onomichi 722-8503, Japan
Masaya Iwamuro, Kazuhide Yamamoto, Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan
Katsuyoshi Takata, Tadashi Yoshino, Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan
Seiji Kawano, Hiroyuki Okada, Department of Endoscopy, Okayama University Hospital, Okayama 700-8558, Japan
Author contributions: Iwamuro M drafted the manuscript; Kawai Y, Kawano S and Okada H critical revised the manuscript for intellectual content regarding endoscopic diagnosis; Takata K and Yoshino T did pathological diagnosis; Yamamoto K made the final approval of the version to be published.
Correspondence to: Dr. Masaya Iwamuro, Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-Ku, Okayama 700-8558, Japan. iwamuromasaya@yahoo.co.jp
Telephone: +81-86-2357219 Fax: +81-86-2255991
Received: July 18, 2012 Revised: August 28, 2012 Accepted: September 18, 2012 Published online: January 16, 2013
Abstract
A 69-year-old Japanese female was diagnosed with primary intestinal follicular lymphoma. Esophagogastroduodenoscopy with high-definition imaging revealed not only the typical feature of whitish polyps of up to 2 mm in diameter in the duodenal second and third portions, but also more detailed morphology, such as enlarged whitish villi and tiny whitish depositions. These findings appeared to reflect the pathological structures; infiltration of lymphoma cells into the villi were probably seen as enlargement of the villi, and the formation of lymphoid follicles were shown as opaque white spots or tiny white depositions. Thus, the above features might contribute to the distinct diagnosis of intestinal follicular lymphoma. This case indicates that routine esophagogastroduodenoscopy can visualize microsurface structures, which can be pathognomonic and help to diagnose intestinal follicular lymphoma, even without magnifying endoscopy.
