title: Primary gastrointestinal follicular lymphoma involving the duodenal second portion is a distinct entity: a multicenter, retrospective analysis in Japan.
abstract: We conducted a multicenter, retrospective study to determine the anatomical distribution and prognostic factors of gastrointestinal (GI) follicular lymphoma (FL). This study included 125 patients with stage I and II(1) GI-FL. Of the 125 patients, the small intestine was examined in 70 patients, with double-balloon endoscopy and/or capsule endoscopy. The most frequently involved GI-FL site was the duodenal second portion (DSP) (81%), followed by the jejunum (40%); 85% of patients with involvement of the DSP also had jejunal or ileal lesions. The absence of abdominal symptoms and macroscopic appearance of multiple nodules were significantly present in the DSP-positive group. During a median follow up of 40 months, six patients showed disease progression. Patients with involvement of the DSP had better progression-free survival (PFS) than those without such involvement (P = 0.001). A multivariate analysis revealed that male sex, the presence of abdominal symptoms, and negative involvement of the DSP were independently associated with poor PFS. In conclusion, most patients with GI-FL have duodenal lesions associated with multiple jejunal or ileal lesions. Gastrointestinal follicular lymphomas involving the DSP might be a distinct entity showing a favorable clinical course.
authors.affiliation: Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Takata
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okada
authors.forename: Naoki
authors.initials: N
authors.lastname: Ohmiya
authors.forename: Shotaro
authors.initials: S
authors.lastname: Nakamura
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Kitadai
authors.forename: Akira
authors.initials: A
authors.lastname: Tari
authors.forename: Taiji
authors.initials: T
authors.lastname: Akamatsu
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kawai
authors.forename: Shu
authors.initials: S
authors.lastname: Tanaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Araki
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshida
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Okumura
authors.forename: Hogara
authors.initials: H
authors.lastname: Nishisaki
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Sagawa
authors.forename: Norihiko
authors.initials: N
authors.lastname: Watanabe
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Arima
authors.forename: Noritaka
authors.initials: N
authors.lastname: Takatsu
authors.forename: Masanao
authors.initials: M
authors.lastname: Nakamura
authors.forename: Shunichi
authors.initials: S
authors.lastname: Yanai
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Kaya
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Morito
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Sato
authors.forename: Hisataka
authors.initials: H
authors.lastname: Moriwaki
authors.forename: Choitsu
authors.initials: C
authors.lastname: Sakamoto
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Niwa
authors.forename: Hidemi
authors.initials: H
authors.lastname: Goto
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Chiba
authors.forename: Takayuki
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ennishi
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Tadashi
authors.initials: T
authors.lastname: Yoshino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D004386:Duodenum / Q000473:pathology*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000401:mortality / Q000473:pathology*; D006801:Humans; D008224:Lymphoma, Follicular / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies