title: Usefulness of double balloon enteroscopy and video capsule endoscopy for the diagnosis and management of primary follicular lymphoma of the gastrointestinal tract in its early stages.
abstract: OBJECTIVE
  The aim of this study is to evaluate the usefulness of double balloon enteroscopy (DBE) and video capsule endoscopy (VCE) in patients with primary follicular lymphoma (FL) of the gastrointestinal (GI) tract. Furthermore, we estimate the effectiveness of chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisone) including rituximab for them.
  
  
  METHODS
  Thirteen consecutive patients who were diagnosed of having FL in the duodenum between July 2005 and September 2008 were studied. All patients were given the conventional staging examinations, including total enteroscopy using DBE and/or VCE procedures. Chemotherapy was performed after written informed consent. Response assessment was performed every 6-12 months. The median follow-up period was 30.2 months.
  
  
  RESULTS
  FL was diagnosed in each patient as low grade (grade 1, n = 7; 2, n = 6) and, in all but 4 patients, localized lymphoma (stage I, n = 8; II(1), n = 1; II(2), n = 4). DBE revealed multifocal lesions in the jejunum in 10 of the patients, and in the ileum in 6. VCE showed similar findings in the jejunum in the recent 2 patients. Eleven of 13 patients finally received chemotherapy, and all of them achieved complete regression. They showed no evidence of recurrence after that.
  
  
  CONCLUSIONS
  Total examination of the small intestine using DBE should be performed before treatment to choose a suitable treatment procedure for primary FL of the GI tract. On the other hand, VCE is useful for screening and following the small intestine in the patients with it. Chemotherapy is effective to achieve complete regression of primary FL of the GI tract.
authors.affiliation: Department of Endoscopy, Shinshu University Hospital, Matsumoto, Japan. ta07260@shinshu-u.ac.jp
authors.forename: Taiji
authors.initials: T
authors.lastname: Akamatsu
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Kaneko
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Ota
authors.forename: Hideharu
authors.initials: H
authors.lastname: Miyabayashi
authors.forename: Norikazu
authors.initials: N
authors.lastname: Arakura
authors.forename: Eiji
authors.initials: E
authors.lastname: Tanaka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053704:Capsule Endoscopy; D004379:Duodenal Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D007078:Ileal Neoplasms / Q000175:diagnosis / Q000473:pathology; D007414:Intestinal Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D007421:Intestine, Small / Q000473:pathology*; D007580:Jejunal Neoplasms / Q000175:diagnosis / Q000473:pathology; D008224:Lymphoma, Follicular / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged