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Follicular Lymphoma Mimicking Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma of the Duodenum, which Improved after Helicobacter pylori Eradication, Report of a Case Madoka Yanaga 1 , Ryuichiro Maekawa 1 , Ichiro Miyajima 1 , Shinichi Iwanaga 1 , Ryo Tanabe 1 1Department of Internal Medicine, Social Insurance Tagawa Hospital Keyword: follicular lymphoma , MALTリンパ腫 , Hp , 除菌療法 pp.1433-1438
Published Date 2005/9/25
DOI https://doi.org/10.11477/mf.1403100242
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 Malignant lymphoma of the duodenum is a rare disease. MALToma in the stomach has been intensively investigated, but in the duodenum it is so rare that its characteristic appearance has not been described in detail.

 Besides, differential diagnosis between MALToma and other malignant lymphoma, (follicular lymphoma, mantle cell lymphoma) is difficult.

 A 59-year-old woman who had taken a medical examination was transferred to our hospital for the further examination. The first endoscopic examination showed multiple tiny round nodules in the duodenum. Biopsy specimen revealed lymphoid follicles, and immunohistochemical examination revealed negative immunoreactivity for CD10 but positive immunoreactivity for CD20. We were not able to diagnose the lesion as MALToma. Concerning H. pylori, only serum Hp antibody was positive. After thirteen months, endoscopic examination showed that the round nodules had spontaneously reduced.

 However, at this time, immunohistochemical findings revealed immunoreactivity positive for CD20 and negative for CD10 and bcl-2, so we diagnosed the lesion as MALToma. We performed eradication therapy. Seventeen months after eradication of Hp, the tiny round nodules were found to have reduced.

 Afterwards, we investigated the immunohistology of the lymph folliclar lesion positive for CD10 and bcl-2, which was seen at the first examination.

 This enabled us to diagnose this case as follicular lymphoma from the beginning.

 In future, we should investigate many such cases so as to make accurate diagnosis and provide effective treatment for this type of lymphoma.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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