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Atypical jejunal follicular lymphoma with severe stricture

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Abstract

The typical macroscopic appearance of gastrointestinal follicular lymphoma (FL) are multiple white granules or small white polyps, called multiple lymphomatous polyposis type, and subsequent mass lesions with or without ulceration; however, an ulcer type with a stricture is extremely rare. We report a case of a 79-year-old male with severe jejunal stricture due to FL with an uncommon chromosomal translocation t(2;18)(p12;q21). The patient was treated with jejunectomy subsequent rituximab monotherapy with a favorable response. The presence of the stricture made its endoscopic diagnosis confusing; however, it was certainly accompanied by the distinctive white granules on the surface of the tumor as seen in typical FL. With the possibility of an FL with stricture in mind, it is important to collect subtle endoscopic findings of the surrounding mucosa carefully, in order to arrive at an accurate endoscopic diagnosis and eventually to the proper therapeutic option.

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Abbreviations

FL:

Follicular lymphoma

DLBCL:

Diffuse large B cell lymphoma

DBE:

Double-balloon enteroscopy

MLP:

Multiple lymphomatous polyposis

FDG PET/CT:

Fluorodeoxyglucose positron emission tomography/computed tomography

BCL2:

B cell lymphoma 2

G-band:

Giemsa-banding

IG:

Immunoglobulin

R-CHOP:

Rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy

M:

Male

F:

Female

ND:

Not described

SUV:

Standardized uptake value

EGD:

Esophagogastroduodenoscopy

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Authors and Affiliations

  1. Department of Gastroenterology, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan

    Hiroki Goto, Yu Sasaki, Takashi Kon, Naoko Mizumoto, Takayuki Sakai, Minami Ito, Matsuki Umehara, Shuhei Nakamura, Hidemoto Tsuchida & Yoshiyuki Ueno

  2. Division of Endoscopy, Yamagata University Hospital, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan

    Yasuhiko Abe & Makoto Yagi

Authors
  1. Hiroki Goto
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  2. Yu Sasaki
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  3. Yasuhiko Abe
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  4. Takashi Kon
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  5. Naoko Mizumoto
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  6. Makoto Yagi
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  7. Takayuki Sakai
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  8. Minami Ito
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  9. Matsuki Umehara
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  10. Shuhei Nakamura
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  11. Hidemoto Tsuchida
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  12. Yoshiyuki Ueno
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Corresponding author

Correspondence to Yu Sasaki.

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Conflict of interest

Hiroki Goto, Yu Sasaki, Yasuhiko Abe, Takashi Kon, Naoko Mizumoto, Makoto Yagi, Takayuki Sakai, Minami Ito, Matsuki Umehara, Shuhei Nakamura, Hidemoto Tsuchida, and Yoshiyuki Ueno declare that they have no conflict of interest.

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All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Informed consent was obtained from all patients for being included in the study.

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Goto, H., Sasaki, Y., Abe, Y. et al. Atypical jejunal follicular lymphoma with severe stricture. Clin J Gastroenterol 15, 101–106 (2022). https://doi.org/10.1007/s12328-021-01530-3

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  • DOI: https://doi.org/10.1007/s12328-021-01530-3

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