title: [Clinicopathologic analysis of intestinal follicular lymphoma first presenting with gastrointestinal symptoms].
abstract: OBJECTIVE
  To study the clinical features, endoscopic findings, pathologic diagnosis and treatment options of intestinal follicular lymphoma first presenting with gastrointestinal symptoms.
  
  
  METHODS
  The clinical features, pathologic findings and follow-up data were retrospectively studied in 9 cases of intestinal follicular lymphoma. Immunohistochemical study for CD3, CD5, CD20, CD21, Ki-67, bcl-2, bcl-6, CD10 and cyclin D1 was carried out.
  
  
  RESULTS
  Seven of the 9 patients were females and two were males. The age of patients ranged from 5 to 60 years (mean = 44 years). The clinical manifestations included abdominal pain (5 cases), blood in stool (3 cases) and abdominal distension (1 case). The commonest site of involvement was ileocecal region (6/9). Endoscopic examination had been carried out in 6 patients and all showed the presence of multiple polyps. Five cases had undergone endoscopic biopsy. Histologic examination of the endoscopic biopsies showed lymphoma cells located mainly in mucosal layer, forming vague nodules with ill-defined boundaries. Plasma cells and eosinophils were not conspicuous. Immunohistochemically, the tumor cells in all cases diffusely expressed CD20, CD10 and bcl-2. The staining for CD3, CD5 and cyclin D1 was negative. Lymphoid cells with weak CD10-positivity were identified in the interfollicular regions. Four cases were treated with surgical resection and chemotherapy. The other 3 cases received chemotherapy only and the remaining cases were treated conservatively. All of them were still alive on follow up.
  
  
  CONCLUSIONS
  Primary intestinal follicular lymphoma affects predominantly elderly patients and has a female predilection. The commonest site of involvement is ileocecal region. Endoscopic examination shows polypoid changes. The disease often runs a relatively indolent clinical course. The prognosis is better than that of primary nodal follicular lymphoma.
authors.affiliation: Department of Pathology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Jian-lan
authors.initials: JL
authors.lastname: Xie
authors.forename: Yan
authors.initials: Y
authors.lastname: Jin
authors.forename: Xiao-dan
authors.initials: XD
authors.lastname: Zheng
authors.forename: Xue-jing
authors.initials: XJ
authors.lastname: Wei
authors.forename: Hong
authors.initials: H
authors.lastname: Zhu
authors.forename: Yuan-yuan
authors.initials: YY
authors.lastname: Zheng
authors.forename: Shu-hong
authors.initials: SH
authors.lastname: Zhang
authors.forename: Yan-ning
authors.initials: YN
authors.lastname: Zhang
authors.forename: Guang-yong
authors.initials: GY
authors.lastname: Chen
authors.forename: Xiao-ge
authors.initials: XG
authors.lastname: Zhou
mesh_terms: D015746:Abdominal Pain / Q000473:pathology; D000328:Adult; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D018951:Antigens, CD20 / Q000378:metabolism; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004317:Doxorubicin / Q000627:therapeutic use; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007414:Intestinal Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D008214:Lymphocytes / Q000473:pathology; D008224:Lymphoma, Follicular / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015260:Neprilysin / Q000378:metabolism; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism; D012189:Retrospective Studies; D000069283:Rituximab; D012737:Sex Factors; D014750:Vincristine / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D019253:Proto-Oncogene Proteins c-bcl-2; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D015260:Neprilysin; D011241:Prednisone