A case of primary duodenal follicular lymphoma

Abstract

The patient was a 65-year-old man with a chief complaint of right-sided abdominal discomfort. He had been undergoing yearly upper gastrointestinal endoscopy after receiving endoscopic therapy for early-stage gastric cancer in 2006. An upper gastrointestinal endoscopy performed in 2012 detected white granular lesions that had accumulated near the papilla of Vater at the descending part of the duodenum. Based on the results of a biopsy, the patient was diagnosed with follicular lymphoma and was admitted for detailed examination. Systemic computed tomography performed after admission found no swelling of the lymph nodes or metastasis to other organs, and scintigraphy showed no abnormal accumulation of gallium. Therefore, the patient was classified as Stage I according to the Lugano International Conference classification. A total of six courses of single-agent chemotherapy with rituximab were administered and completed without serious adverse reactions. The duodenal lesions subsequently disappeared, and no tumor cells were identified within biopsy specimens obtained in the follow-up upper gastrointestinal endoscopy. It is necessary to check the presence of recurrence of follicular lymphoma by periodic upper gastrointestinal endoscopy.