Abstract
Follicular lymphomas occasionally arise in the extra-nodal organs and frequently found in the duodenum. We report a case of follicular lymphoma in the duodenal papilla which is followed up with no treatment about 72 months. In February 2004, a 52-year old female with anemia was diagnosed with limphoproliferative disease by upper endoscopy and biopsy. Endoscopy revealed multiple small polyps in the duodenal papilla. After eradication therapy of Helicobacter pylori, she was followed up, and she showed no remarkable endoscopic change. In July 2006, she re-diagnosed with follicular lymphoma by under endoscopic biopsy. Immunohistochemically, the tumor cells were positive for CD20, CD79, CD10, Bcl-2 and Bcl-6, and were negative for CD3 and CD5. MIB-1 positive cells were 10-20%. After the diagnosis, she followed up with no treatment about 72 months because she did not want treatment such as chemotherapy, surgical resection and radiation, and because she showed no remarkable progressive endoscopic change. It is suggested that following up with no treatment is might able to the choice of treatment of follicular lymphoma in the duodenal papilla.
