title: Primary duodenal follicular lymphoma: 6-years complete remission after combined radio-immunotherapy.
abstract: Primary gastrointestinal lymphoma (PGL) is known to account for 40% of all extranodal non-Hodgkin's lymphomas (NHLs) and between 4% to 12% of all NHLs. The small intestine is the site of presentation in 20-30% of cases, with the terminal ileum usually involved. Duodenal localizations have always been thought to be rare, but are presently growing in incidence. We herein report on a case of Stage IV primary duodenal FCL, located to the second portion of the duodenum with concomitant minimal bone marrow involvement. The patient was frontline approached with a conservative combined modality treatment consisting of 4 weekly infusions of the chimeric human-murine IgG1 mono-clonal antibody against the B-cell surface antigen CD-20, Rituximab (375 mg/m2) and consolidation 3D conformal external beam radiotherapy up to a total dose of 36 Gy given into 20 fractions to the involved duodenal portion. Six years after treatment has been completed, the patient is free from disease with no treatment-related toxicity.
authors.affiliation: Department of Medical and Surgical Sciences, Radiation Oncology Unit, University of Torino, Ospedale S. Giovanni Battista, Turin, Italy. pierfrancesco.franco@gmail.com
authors.forename: Pierfrancesco
authors.initials: P
authors.lastname: Franco
authors.forename: Andrea Riccardo
authors.initials: AR
authors.lastname: Filippi
authors.forename: Patrizia
authors.initials: P
authors.lastname: Ciammella
authors.forename: Angela
authors.initials: A
authors.lastname: Botticella
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Namysl-Kaletka
authors.forename: Alberto
authors.initials: A
authors.lastname: De Crescenzo
authors.forename: Corrado
authors.initials: C
authors.lastname: Tarella
authors.forename: Umberto
authors.initials: U
authors.lastname: Ricardi
mesh_terms: D000328:Adult; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D004379:Duodenal Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000532:radiotherapy*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D008224:Lymphoma, Follicular / Q000175:diagnosis / Q000188:drug therapy / Q000532:radiotherapy*; D009367:Neoplasm Staging; D012074:Remission Induction; D000069283:Rituximab
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab