2019 Volume 61 Issue 8 Pages 1561-1568
A 73-year-old woman complained of diarrhea, bloody stools, and weight loss. Colonoscopy revealed diverse elevated lesions in the entire colon. Esophagogastroduodenoscopy revealed whitish nodules and granules from the horizontal part of the duodenum to the bulbus. The pathological diagnosis based on the biopsy specimens from the colon and duodenal lesions was follicular lymphoma. Further examination revealed enlargement of multiple lymph nodes, invasion of lymphoma cells to the spleen, and bone marrow infiltration. Conclusively, we diagnosed her with follicular lymphoma grade 1, Ann Arbor stage IVB, and as being at high risk in the Follicular Lymphoma International Prognostic Index. Six courses of chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone therapy) were administered, and complete remission was achieved based on the subsequent image-based examination. Cases with findings of follicular lymphoma typical of the duodenum and multiple lymphomatous polyposis in the entire colon are relatively rare.
