Abstract
A 39-year-old male was admitted to our hospital because of abdominal distension. Double contrast study of the upper gastrointestinal tract revealed the broad-based polypoid lesion in the duodenal bulb. Endoscopy revealed nodular broad-based polypoid lesion without ulceration on the anterior wall of the duodenal bulb. The biopsy specimen taken from this lesion revealed atypical lymphocytes, and malignant lymphoma was strongly suspected. No localized lesions were found in the esophagus, stomach, small intestine, and colon on radiographic study and endoscopy. Chest X-ray, abdominal ultrasonography, and whole body computer tomography revealed no lymphadenopathy, and finding of the bone marrow was normal. Thus, the patient was diagnosed as primary malignant lymphoma of the duodenal bulb. Gastroduodenal resection was performed. The nodular broad-based polypoid lesion was found in the duodenal bulb of the resected specimen. Histology of this lesion revealed evidence of non-Hodgikin lymphoma, showing diffuse pleomorphic type. Immunohis-tologically, tumor cells showed T-cell type. We reported primary malignant lymphoma of the duodenal bulb, showing T-cell type, and this case was extremely rare.
