title: Follicular lymphoma-related colitis resembling ulcerative colitis.
abstract: Among the various manifestations of colonic involvement in malignant lymphomas, an ulcerative colitis-like appearance is rare. Herein, we describe a case in which extranodal colonic involvement resembled ulcerative colitis in a patient with advanced follicular lymphoma. A 59-year-old Japanese man with diarrhea and body weight loss was referred to our hospital. Computed tomography (CT) revealed systemic lymphadenopathy, splenomegaly, and thickening of the sigmoid colon and rectum walls.18F-fluorodeoxy-glucose positron emission tomography (18F-FDG-PET/CT) revealed intense tubular18F-FDG accumulation extending from the rectum to the colon at the hepatic flexure and much weaker accumulation in the systemic lymph nodes, bone marrow, and spleen. The isotope-enriched areas had an ulcerative colitis-like appearance as shown via colonoscopy. The patient was ultimately diagnosed with follicular lymphoma (stage IV A, grade 1) based on a pathological examination of the neck lymph nodes, iliac bone marrow, and colon. After six courses of chemotherapy (R-CHOP),18F-FDG-PET/CT confirmed complete remission of the lymphoma including the colonic lesion. This is presumably the first case of ulcerative-like colitis caused by a follicular lymphoma. As a novel approach, the lymphoma-related colitis was detected by comparing the pathology results and the18F-FDG-PET/CT results.
authors.affiliation: Department of Internal Medicine, Asanogawa General Hospital, Kosaka-Naka 83, Kanazawa, 920-8621, Japan. zenda@asanogawa-gh.or.jp.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Zenda
authors.affiliation: Department of Internal Medicine, Asanogawa General Hospital, Kosaka-Naka 83, Kanazawa, 920-8621, Japan.|Department of Hematology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
authors.forename: Noriharu
authors.initials: N
authors.lastname: Nakagawa
authors.affiliation: Department of Internal Medicine, Keijyu Kanazawa Hospital, Kanazawa, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Maruyama
authors.affiliation: Department of Radiology, Asanogawa General Hospital, Kanazawa, Japan.
authors.forename: Tamao
authors.initials: T
authors.lastname: Endo
authors.affiliation: Department of Radiology, Asanogawa General Hospital, Kanazawa, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Higashi
authors.affiliation: Department of Otolaryngology, Asanogawa General Hospital, Kanazawa, Japan.
authors.forename: Junpei
authors.initials: J
authors.lastname: Yamamoto
authors.affiliation: Department of Pathology, Asanogawa General Hospital, Kanazawa, Japan.
authors.forename: Keigo
authors.initials: K
authors.lastname: Komai
authors.affiliation: Department of Pathology, Asanogawa General Hospital, Kanazawa, Japan.|Watanabe's Consultancy for Pathological Diagnosis, Kanazawa, Japan.
authors.forename: Kishichiro
authors.initials: K
authors.lastname: Watanabe
authors.affiliation: Department of Internal Medicine, Asanogawa General Hospital, Kosaka-Naka 83, Kanazawa, 920-8621, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Araki
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D003093:Colitis, Ulcerative / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D003113:Colonoscopy / Q000379:methods; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D006801:Humans; D007420:Intestine, Large / Q000473:pathology; D008224:Lymphoma, Follicular / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods; D011241:Prednisone / Q000627:therapeutic use; D000069283:Rituximab; D014057:Tomography, X-Ray Computed / Q000379:methods; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
keywords: 18F-FDG-PET/CT; Follicular lymphoma; Lymphoma-related colitis; Lymphomatous colitis; Ulcerative colitis