Duodenal Follicular Lymphoma: Track or Treat?

Abstract

Duodenal follicular lymphoma (DFL) is a rare variety of non-Hodgkin's lymphoma of the gastrointestinal tract that usually carries a favorable course, recognized as a new entity in 2016. It is usually diagnosed at an early stage located predominantly in the second portion of the duodenum. We report the case of a 74-year-old male patient with epigastric pain in whom gastroscopy revealed white mucosal nodules that were pathologically diagnosed as grade 1-2 DFL. Staging investigations revealed secondary lesions in the spleen and at the base of the tongue together with latero-cervical adenopathy. The tumor was stage IV according to the Lugano staging system. We reviewed the recent (last five years) literature defining the importance of combination therapy in the advanced stage. The patient achieved complete remission of the disease through chemoimmunotherapy following the Rituximab-Bendamustine scheme.

Role of Small Bowel Capsule Endoscopy in Determining the Treatment Strategy for Duodenal Follicular Lymphoma: A Single-Center Retrospective Study

“…Systemic chemotherapy based on rituximab can be considered the most de nitive treatment alternative, given its highly evident therapeutic effects [14]. Moreover, compared to NFL, a reduced presence of effector regulatory T cells within neoplastic follicles was noted in DFL, which could explain the stronger antitumor responses observed.…”