Small intestinal follicular lymphoma with multiple tumor formations diagnosed by double-balloon enteroscopy

Follicular lymphoma of the small intestine remains relatively rare, especially in its early stage. Recently, double-balloon endoscopy has enabled observation of the entire small intestine. We describe a case of follicular lymphoma with multiple lesions in the small intestine detected by double-balloon endoscopy. The patient showed multiple whitish granules in descending portion of the duodenum on screening esophagogastroduodenoscopy, which were subsequently diagnosed as follicular lymphoma by immunohistochemistry. Endoscopic examination of the entire small intestine revealed multiple follicular lymphoma tumors in inferior portion of the duodenum and in the proximal jejunum. Double-balloon endoscopy is useful for evaluating tumor distribution of follicular lymphoma.