Pathological features of duodenal-type follicular lymphoma
10.3760/cma.j.issn.0529-5807.2019.01.005
- VernacularTitle: 十二指肠型滤泡性淋巴瘤病理学特征
- Author:
Fen ZHANG
1
;
Donglan LUO
;
Yu CHEN
;
Jiao HE
;
Jinhai YAN
;
Luqiao LUO
;
Xinlan LUO
;
Yanhui LIU
Author Information
1. Department of Pathology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou 510080, China
- Publication Type:Journal Article
- Keywords:
Lymphoma, follicular;
Pathology, clinical;
Prognosis
- From:
Chinese Journal of Pathology
2019;48(1):22-25
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinicopathological features, treatment and prognosis of duodenal-type follicular lymphoma.
Methods:Four cases of duodenal-type follicular lymphoma diagnosed at Guangdong General Hospital from 2014 to 2015 with detailed clinical data were included. The histomorphology, immunophenotype, treatment and prognoses were analyzed.
Results:The patients′ age ranged from 51 to 57 years (mean 54 years), and there were 2 males and 2 females. The involved sites were gastric fundus in one case, second portion of the duodenum in two cases and terminal ileum in one case. All patients presented with multiple mucosal granules or nodules at endoscopy. Microscopically, there were multiple mucosal neoplastic follicles, constituting grade 1-2 disease based on nodal follicular lymphoma grading system. The tumor cells were positive for CD20, CD10, bcl-6 and bcl-2. CD21 highlighted the follicular dendritic meshwork mainly at the periphery of the follicles. Proliferation index was low. Three patients received rituximab monotherapy for 4 cycles, leading to complete remission. One patient refused therapy and the disease progressed to systemic lymphoma 15 months after the initial diagnosis.
Conclusions:Duodenal-type follicular lymphoma is a special variant of follicular lymphoma with indolent clinical course. The tumor exhibits morphology of low grade follicular lymphoma with characteristic dendritic meshwork at the periphery of the follicles and a low proliferation index. Prognosis is excellent. Rituximab monotherapy is treatment of choice, but a small minority of patients may progress to systemic disease.
