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Colorectal follicular lymphoma: A case report
Mei-Lian Wang1, Jiang Chang, Hua Huang
1Department of Gastroenterology, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China.
Medicine
|January 18, 2019
Summary
This case review highlights colorectal follicular lymphoma (FL), a rare cancer. Effective treatment with chemotherapy and rituximab led to complete remission and no recurrence in a patient with stage IV disease.
Area of Science:
- Gastroenterology
- Hematology
- Oncology
Background:
- Colorectal follicular lymphoma (FL) is rare, with limited data on its diagnosis and treatment.
- Clinical presentation and endoscopic findings are often non-specific, posing diagnostic challenges.
Observation:
- A 27-year-old female presented with severe bloody stool and melena, indicative of gastrointestinal bleeding.
- Colonoscopy revealed widespread flat polyps with specific immunophenotypes (CD10+, BCL2+, BCL6+, cyclin D1-, CD5-) in the colorectal region.
- Positron emission tomography-computed tomography (PET/CT) confirmed stage IV colorectal FL.
Findings:
- The patient received a combination chemotherapy regimen (rituximab, cyclophosphamide, liposomal doxorubicin, vincristine sulfate, and hydroprednisone - R-CHOP) with etoposide, followed by rituximab monotherapy.
- Post-treatment PET/CT reexamination showed a significant reduction in tumor burden, with complete disappearance of lesions.
- No recurrence was noted during a 12-month follow-up period, indicating a favorable treatment response.
Implications:
- Colorectal FL, often presenting as multiple polyps, typically follows an indolent course, commonly affecting the ileocecal area.
- Interventional treatment is initiated based on clinical symptoms or disease progression.
- The successful management of this stage IV case highlights the efficacy of current therapeutic strategies and suggests a good prognosis for colorectal FL.
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