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Gastrointestinal follicular lymphoma: Current knowledge and future challenges
Author(s) -
Takata Katsuyoshi,
MiyataTakata Tomoko,
Sato Yasuharu,
Iwamuro Masaya,
Okada Hiroyuki,
Tari Akira,
Yoshino Tadashi
Publication year - 2018
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/pin.12621
Subject(s) - pathology , duodenum , lymphoma , follicular lymphoma , gastrointestinal tract , cd99 , immunophenotyping , medicine , biology , immunohistochemistry , antigen , immunology , vimentin
The gastrointestinal (GI) tract is the most commonly involved site of extranodal follicular lymphoma (FL). GI‐FL shows very indolent clinical behavior and localized at GI tract without any progression or transformation compared to nodal FL. The most frequently involved site of the GI tract was the duodenum followed by the jejunum and ileum, and only 15% of FL arising in the second part of the duodenum were localized there without scattered very small daughter lesions in other GI tract examined by double‐balloon endoscopy. The typical macroscopic appearance of GI‐FL was multiple white nodules. Microscopically, neoplastic cells were small‐ to medium‐sized lymphoid cells and formed neoplastic follicles. Most of the cases (>95%) were histologically Grade 1 to 2 (low grade). Several pathological and molecular characteristics were seen in GI‐FL (especially duodenal FL) compared with nodal FL: immunoglobulin heavy chain deviation to VH4 and VH5; memory B‐cell immunophenotype; and molecular features shared by mucosa‐associated lymphoid tissue lymphoma. Considering the pathological and molecular uniqueness of this disease, GI‐FL should be separately managed from nodal FL.