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Follicular lymphoma with extensive gastrointestinal tract involvement: follow-up by capsule endoscopy
Boris Sapoznikov1, Sarah Morgenstern, Pia Raanani
1Department of Gastroenterology, Rabin Medical Center, Tel Aviv University, Beilinson Campus, Petah Tiqwa 49100, Israel.
Insights
Follicular lymphoma rarely affects the gastrointestinal tract. This case highlights how capsule endoscopy and molecular analysis precisely diagnosed and evaluated small bowel involvement in a young woman with chronic diarrhea.
Area of Science:
- Gastroenterology
- Oncology
- Pathology
Background:
- Follicular lymphoma (FL) is a common non-Hodgkin lymphoma, but its involvement in the gastrointestinal tract is infrequent.
- Gastrointestinal FL can present with nonspecific symptoms, making diagnosis challenging.
Observation:
- A young woman presented with chronic diarrhea, found to have multiple nodular lesions in the proximal jejunum and terminal ileum.
- Diagnosis was confirmed through endoscopy, histology, immunohistochemistry, and molecular analysis of small bowel mucosal biopsies.
Findings:
- Videocapsule endoscopy was instrumental in assessing the initial spread and pattern of small bowel involvement.
- Molecular analysis and immunophenotypic evaluation were crucial for accurate follicular lymphoma diagnosis.
- Capsule endoscopy effectively monitored treatment response and the extent of small bowel involvement.
Implications:
- This case underscores the utility of advanced diagnostic tools like capsule endoscopy and molecular analysis in rare gastrointestinal malignancies.
- Accurate staging and monitoring are vital for effective management of follicular lymphoma in the gastrointestinal tract.
- Early and precise diagnosis can lead to improved patient outcomes for rare gastrointestinal cancers.
Abstract:
Follicular lymphoma with gastrointestinal tract involvement is rare. We describe the case of a young woman with follicular lymphoma with multiple nodular lesions involving segments of the proximal jejunum and terminal ileum. The presenting symptom was chronic diarrhea. The diagnosis was made by endoscopy with histologic examination of the mucosal lesions of the proximal and distal small intestine, immunohistochemical staining, and molecular analysis. The initial spread and pattern of the small bowel involvement, as well as treatment response, were evaluated by videocapsule endoscopy. The application of molecular analysis along with immunophenotypic evaluation has made it possible to precisely diagnose follicular lymphoma. In the present case, the use of capsule endoscopy improved the evaluation of the extent of small bowel involvement prior to and following treatment.
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