Duodenal follicular lymphomas share common characteristics with mucosa-associated lymphoid tissue lymphomas.
Abstract
Backgrounds: Follicular lymphomas occasionally arise in the extra-nodal organs. We previously reported that they rather frequently found in the duodenum. They are often localized tumor with multiple polyps around the ampulla of Vater.
Methods: We attempted to examine a IgH/bcl-2 hybrid gene and VH-gene usage to know the nature of the lymphoma cells: how difference to nodal follicular lymphomas and to MALT lymphomas. We have experienced 35 patients with duodenal follicular lymphoma after our latest report (40 patients in total), and we examined clinicopathological characters in details.
Results: Out of 40 in total, 37 were determined in clincial stage I (30) or stage II(7). It is quite different from a datum of previous report on nodal follicular lymphomas (p<0.001). PCR analyses, clonal immunoglobulin gene rearrangement was detected in 53.3% of examined cases, and rearrangement of IgH/bcl-2 gene at the major break point was detected by in 27% cases may indicate similar to that of nodal ones. VH usage of them revealed that 3 out of 8 examined cases was VH4 (38%), and 2 out of them were VH4-34. As VH4 deviation is the one of the common characters of MALT lymphomas and two out of three were idential usage, duodenal folliucular lymphomas might arise from responding to a kind of causative agent similar to MALT lymphomas. And it showed very indolent clinical course regardless various therapeutic ways, which also resembled clinical features of MALT lymphomas.
Conclusions: These data might suggest that duodenal follicular lymphomas have intermediate characteristics of MALT lymphomas and nodal follicular lymphomas.
