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A 70-year-old asymptomatic woman underwent screening esophagogastroduodenoscopy, which revealed a bulging minor duodenal papilla with redness and rough surface (▶Fig. 1 a – c). Biopsy was suggestive of adenocarcinoma. Laboratory data included normal blood counts and standard serum biochemical tests. Abdominal computed tomography (CT) showed a slightly contrast-enhanced duodenal tumor, approximately 1 cm in size without regional lymphadenitis in the second part of the duodenum; however, choledocholith was also noted incidentally (▶Fig. 2 a). Magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography (ERCP) showed a normal pancreatic duct (▶Fig. 2 b, c) and choledocholith. The choledocholith was removed and endoscopic biliary stenting was performed by ERCP. We then performed endoscopic papillectomy of the minor duodenal papilla to confirm the diagnosis (▶Fig. 1 d– f, ▶Video 1). Histological and immunohistochemical examination revealed follicular lymphoma Grade 1, which was positive for CD20/CD10/BCL-2 but negative for CD3/CD5/BCL1 (▶Fig. 3). Bone marrow biopsy showed no abnormal findings; however, 18-F fluorodeoxyglucose-positron emission tomography/ computed tomography revealed uptake in the third part of the duodenum and surrounding lymph node (▶Fig. 2d), indicating a diagnosis of stage II1 (Lugano International Conference Classification). The patient progressed well after endoscopic papillectomy and was discharged 10 days postoperatively. Following advice from the hematologist, the patient E-Videos

Follicular lymphoma Grade 1 of the minor duodenal papilla successfully diagnosed by endoscopic papillectomy