title: A case report of the histologic transformation of primary follicular lymphoma of the duodenum.
abstract: A 46-year-old woman underwent upper endoscopy for evaluation of anemia, which revealed whitish granules at the duodenal papilla, diagnosed as duodenal follicular lymphoma (DFL) by biopsy. Computed tomography and abdominal ultrasonography revealed that follicular lymphoma was confined to the duodenum. Seven years after the diagnosis, fluorine-18 fluorodeoxyglucose positron emission tomography scanning revealed multiple lesions including in bone marrow and lymph nodes. Bone marrow biopsy of the right iliac bone revealed diffuse large B-cell lymphoma, indicating systemic dissemination and histologic transformation of the DFL. The patient responded to chemotherapy and has been progression-free for 2.5 years. Although DFL is usually indolent even without any treatment, systemic dissemination with histologic transformation can occur. This case suggests that the life-time follow-up that is usually done for patients with nodal follicular lymphoma should be provided to patients with DFL.
authors.affiliation: From the Department of Hematology (KI, AW); Department of Gastroenterology (SA, TI, OO, KT); Department of Pathology, Tokyo(YO); and Department of Hematology, Toranomon Hospital Kajigaya, Kawasaki, Japan (AW).
authors.forename: Shintaro
authors.initials: S
authors.lastname: Akiyama
authors.forename: Koji
authors.initials: K
authors.lastname: Izutsu
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Ota
authors.forename: Tsunao
authors.initials: T
authors.lastname: Imamura
authors.forename: Osamu
authors.initials: O
authors.lastname: Ogawa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Wake
authors.forename: Kazuo
authors.initials: K
authors.lastname: Takeuchi
mesh_terms: D001859:Bone Neoplasms / Q000175:diagnosis* / Q000628:therapy; D002471:Cell Transformation, Neoplastic; D004379:Duodenal Neoplasms / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D007085:Ilium; D008224:Lymphoma, Follicular / Q000473:pathology* / Q000628:therapy; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000628:therapy; D008875:Middle Aged