Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Clinical insights into duodenal-type follicular lymphoma: case series study

  • A Reum Choe (Department of Internal Medicine, Ewha Womans University College of Medicine) ;
  • Ye Ji Jun (Department of Internal Medicine, Ewha Womans University College of Medicine) ;
  • Min-Sun Cho (Department of Pathology, Ewha Womans University College of Medicine) ;
  • Chung Hyun Tae (Department of Internal Medicine, Ewha Womans University College of Medicine) ;
  • Sung-Ae Jung (Department of Internal Medicine, Ewha Womans University College of Medicine) ;
  • Ki-Nam Shim (Department of Internal Medicine, Ewha Womans University College of Medicine)
  • Received : 2025.03.11
  • Accepted : 2025.05.09
  • Published : 2025.07.30
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Abstract

In Asia, widespread early detection through endoscopic screening has resulted in higher diagnosis rates of asymptomatic duodenal-type follicular lymphoma (DFL). However, no standardized guidelines exist for diagnosing and managing DFL, and ongoing debates persist regarding the optimal treatment strategies. This retrospective observational study was conducted between February 2018 and July 2024. Endoscopic examination revealed small whitish nodular lesions in the second portion of the duodenum. Seven patients (58.0%) underwent involved-site radiation therapy. Two patients (17.0%) with stage IV disease underwent chemotherapy with rituximab combined with cyclophosphamide, doxorubicin, vincristine, and prednisolone. Another two (17.0%) received chemotherapy with rituximab combined with cyclophosphamide, vincristine, and prednisone. One patient (8.0%) was treated with rituximab monotherapy. During a median follow-up of 30.2 months, no cases of disease progression were observed. Although radiation and chemotherapy are effective treatments, the slow progression of the disease may make a watch-and-wait strategy appropriate.

Keywords

Acknowledgement

The authors thank Dr. Wonguen Jung, Department of Radiation Oncolocy, Ewha Womans University College of Medicine, for her valuable contributions and expertise in this study.

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