Authors: Akira Tari Yasuharu Sato Hideki Asaoku Masaki Kunihiro Akira Fukumoto Shinji Tanaka Megumu Fujihara Tadashi Yoshino
Publish Date: 2010/09/21
Volume: 43, Issue: 3, Pages: 174-177
Abstract
This is a case report of a 66yearold woman who consulted us with a 1week history of postprandial epigastric discomfort and dyspepsia Upper and lower gastrointestinal endoscopy and doubleballoon enteroscopy revealed lesions in three parts a swelling with a shallow depression in the ampulla of Vater flat and rough nodules in the jejunum and a mixture of lymphoid polyposis and rough surface of follicular lymphoma of the terminal ileum and Bauhin valve The histological immunophenotypic and molecular findings of the duodenal lesion confirmed the diagnosis of follicular lymphoma We initially diagnosed the ileal lesion as MALT lymphoma immunohistochemically However Southern blot hybridization analysis for immunoglobulin heavy chain gene rearrangement showed identical monoclonal bands in both the duodenal and ileal lesions The molecular cytogenetic studies were also positive for the 1418 translocation in both lesions Therefore the true diagnosis of this ileal lesion should be a follicular lymphoma with marginal zone differentiation Primary follicular lymphomas of gastrointestinal tract were suggested to have intermediate features between nodal follicular lymphoma and MALT lymphoma This case is an important clue to prove the similarity of follicular lymphoma of gastrointestinal tract to MALT lymphoma and will be crucial in considering the therapeutic strategy
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