Linfoma folicular duodenal: causa o hallazgo incidental de dispepsia. Caso Clínico

Viviana Graciela Coellar Cando; Ana Gabriela  Sangurima Robalino; Fernando Vinicio Benitez Pardo; Lorena Michell Uyaguari Díaz; Diego Andrés Jimenez Larriva

doi:10.26871/killcanasalud.v9i2.1650

Authors

Viviana Graciela Coellar Cando Servicio de Gastroenterología. Hospital José Carrasco Arteaga https://orcid.org/0009-0000-6275-8333
Ana Gabriela Sangurima Robalino Servicio de Gastroenterología. Hospital José Carrasco Arteaga https://orcid.org/0009-0001-7664-2814
Fernando Vinicio Benitez Pardo Servicio de Gastroenterología. Hospital José Carrasco Arteaga https://orcid.org/0000-0001-5055-4579
Lorena Michell Uyaguari Díaz Servicio de Anatomía Patológica. Hospital José Carrasco Arteaga https://orcid.org/0000-0002-5531-5486
Diego Andrés Jimenez Larriva Servicio de Gastroenterología. Hospital José Carrasco Arteaga https://orcid.org/0009-0000-0466-8823

DOI:

https://doi.org/10.26871/killcanasalud.v9i2.1650

Keywords:

Follicular lymphoma, duodenum, B-cell neoplasia, endoscopy, differential diagnosis

Abstract

Introduction: Primary duodenal follicular lymphoma is a rare, low-grade B-cell neoplasm characterized by an indolent clinical course or by nonspecific symptoms and endoscopic findings. Most cases are diagnosed incidentally during endoscopic procedures. Objective: To describe a case of duodenal follicular lymphoma diagnosed in the context of nonspecific dyspeptic symptoms. Clinical case: A 54-year-old female patient with no relevant medical history presented with intermittent abdominal pain and distension of several years' duration. Due to the persistence of symptoms, an upper gastrointestinal video endoscopy was performed, which identified a mucosa with multiple whitish nodular elevations, with a granular appearance, distributed diffusely, with a cobblestone mucosal pattern and without evident alterations in the vascular pattern. The biopsy was compatible with follicular lymphoma, later confirmed by immunohistochemistry. Conclusion: Primary duodenal follicular lymphoma is a rare entity with a favorable prognosis. Early detection allows for a conservative approach in most cases. The correlation between endoscopic findings and histopathological studies is essential to avoid misdiagnoses and define appropriate management.

Downloads

Download data is not yet available.

References

Cerhan JR. Epidemiology of Follicular Lymphoma. Hematol Oncol Clin North Am. 2020;34(4):631-646. Available in: https://doi.org/10.1016/j.hoc.2020.02.001

Arango Molano LA, Sánchez Gil A, Bautista Parada IR. Linfoma folicular duodenal primario: reporte de caso y revisión de la literatura. Rev Colomb Gastroenterol. 2021;36(4):525-528. Disponible en: https://doi.org/10.22516/25007440.695

Alnughmush A, Fakih RE, Alyamany R, Bakshi N, Alhayli S, Aljurf M. Duodenal-type follicular lymphoma: comprehensive insights into disease characteristics and established treatment strategies. Curr Opin Oncol. 2024;36(6):577-582. Available in: https://doi.org/10.1097/CCO.0000000000001093

Dokmak A, Radwan A, Krishnan S. Primary Gastrointestinal Follicular Lymphoma Exclusively Confined to the Mucosa. Case Rep Gastroenterol. 2022;16(2):496-501. Available in: https://doi.org/10.1159/000525741

Iwamuro M, Tanaka T, Okada H. Review of lymphoma in the duodenum: An update of diagnosis and management. World J Gastroenterol. 2023;29(12):1852-1862. Available in: https://doi.org/10.3748/wjg.v29.i12.1852

Garcia A, Qureshi M, Dhawan I, Allen A, Budak-Alpdogan T, Giordano S. Multifocal Follicular Lymphoma Isolated to the Gastrointestinal Tract: A Rare Finding. ACG Case Reports Journal. 2023;10(12):e01215. Available in: https://doi.org/10.14309/crj.0000000000001215

Hernández Rodríguez M, Figueroa Tubío A, López Jérez A. Linfoma folicular primario duodenal: hallazgo incidental en una gastroscopia de rutina. Rev Gastroenterol México. 2025. Available in: https://doi.org/10.1016/j.rgmx.2025.01.004

Silva JF, Morais R, Fonseca E, Macedo G. A case of duodenal-type follicular lymphoma. Rev Esp Enfermedades Dig. 2021; 114(5): 289-290. Available in: https://doi.org/10.17235/reed.2021.8233/2021

Hirt CK, Bryke CR, Jassim SH. Challenging cases of follicular lymphoma diagnosed by core needle biopsy incorporating proliferation index and cytogenetics. Hum Pathol Rep. 2022;28:300616. Available in: https://doi.org/10.1016/j.hpr.2022.300616

Juanmartiñena Fernández JF, Fernández-Urién I, Iglesias Picazo R, Aznárez Barrio MR, Montes Díaz M, Cebrian García A, et al. Linfoma folicular primario gastrointestinal: hallazgos endoscópicos y papel de la enteroscopia con cápsula. Gastroenterol Hepatol. 2017;40(9):621-623. Available in: https://doi.org/10.1016/j.gastre.2016.07.018

Juma AA, Abubaker F, Sharif O, Aljufairi E. Duodenal-Type Follicular Lymphoma. Gastro Hep Adv. 2023;2(7):943-945. Available in: https://doi.org/10.1016/j.gastha.2023.06.013

Saito M, Mori A, Tsukamoto S, Ishio T, Yokoyama E, Izumiyama K, et al. Duodenal-type follicular lymphoma more than 10 years after treatment intervention: A retrospective single-center analysis. World J Gastrointest Oncol. 2022;14(8):1552-1561. Available in: https://doi.org/10.4251/wjgo.v14.i8.1552

Duffles Amarante G, Collins G, Rocha V. What do we know about duodenal‐type follicular lymphoma? From pathological definition to treatment options. BJHaem. 2020;188(6):831-837. Available in: https://doi.org/10.1111/bjh.16348

Garrido I, Santos-Antunes J, Cardoso H, Macedo G. Duodenal-type follicular lymphoma -a silent tumor. Rev Esp Enfermedades Dig. 2021; 114(8): 489-490. Available in: https://online.reed.es/fichaArticulo.aspx?iarf=688766749237-417274195163.

Encarnacion Minaya MM, Diaz Ferrer J, Moran Tisoc L. Linfoma folicular con afectación duodenal: reporte de caso. Interciencia Médica. 2021;11(2):58-62. Disponible en: https://doi.org/10.56838/icmed.v11i2.27

Kim HJ, Choi J. A Rare Case of Primary Duodenal Follicular Lymphoma. J Dig Cancer Res. 2022;10(1):39-42. Available in: https://doi.org/10.52927/jdcr.2022.10.1.39

Kusuma VP, Vidyani A. Diffuse large B-cell lymphoma from duodenal with hematemesis, melena, and obstruction jaundice symptoms: A rare case. Int J Surg Case Rep. 2023;113:109046. Available in: https://doi.org/10.1016/j.ijscr.2023.109046

Tran QT, Nguyen Duy T, Nguyen-Tran BS, Nguyen-Thanh T, Ngo QT, Tran Thi NP, et al. Endoscopic and Histopathological Characteristics of Gastrointestinal Lymphoma: A Multicentric Study. Diagnostics. 2023;13(17):2767. Available in: https://doi.org/10.3390/diagnostics13172767

Graham RL, Mardones MA, Krause JR. Primary Follicular Lymphoma of the Duodenum. Bayl Univ Med Cent Proc. 2015;28(3):381-383. Available in: https://doi.org/10.1080/08998280.2015.11929284

Kamijo K, Shimomura Y, Yoshioka S, Yamashita D, Hara S, Ishikawa T. Clinical features and outcomes of duodenal‐type follicular lymphoma: A single‐center retrospective study. EJHaem. 2022;3(2):379-384. Available in: https://doi.org/10.1002/jha2.384