Among these secondary gastrointestinal compromise due to nodal follicular lymphoma stands out out because it occurs in advanced stages. Advanced states of the disease are also characterized by superficial thoracic and abdominal lymphadenopathy and marginal zone and mantle lymphoma lymphomatous polyposis. These are principally in the digestive tract, but are unusual in the duodenum where their biological behavior and treatment differ. 1. Isaacson PG, Wright DH. Malignant lymphoma of mucosa associated lymphoid tissue. A distinctive type of B-cell lymphoma. Cancer 1983; 52: 1410-1416. 2. Wotherspoon AC, Ortiz-Hidalgo C, Falzon M, et al. Helicobacter pyloriassociated gastritis and primary B-cell gastric lymphoma. Lancet 1991; 338: 1175-1176. 3. Harris NL, Swerdlow SH, Jaffe ES, Olt G, Nathwani BN, de Jong D, Yoshino T, Spagnolo D. Follicular lymphoma in: Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pireli S, Stein H, Thiele J, Vardiman J. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. 4th Edition. International Agency for Research on Cancer: Lyon-France; 2008. p. 220-228. 4. Nakamura S, Müller- Hermelink HK, Delabie J, Ko YH, Jaffe ES. B cell lymphoma of the small intestine in: Bosman FT, Carneiro F, Hruban RH, Theise DT. WHO Classification of Tumours of the digestive system. 4th Edition. International Agency for Research on Cancer: Lyon-France; 2010. p. 69-73. 5. Nakamura S, Müller- Hermelink HK, Delabie J, Ko YH, van Krieken JH, Jaffe ES. Lymphoma of the stomach in: Bosman FT, Carneiro F, Hruban RH, Theise DT. WHO Classification of Tumours of the digestive system 4th Edition, 2010. International Agency for Research on Cancer: Lyon-France; 2010. p. 108-111. 6. Yamamoto S, Nakase H, Yamashita K, Matsuura M, Takada M, Kawanami C, Chiba T. Gastrointestinal follicular lymphoma: review of the literature. J Gastroenterol 2010; 45: 370-388. 7. Yoshino T, Miyake K, Ichimura K, Mannami T, Ohara N, Hamazaki S, et al. Increased incidence of follicular lymphoma in the duodenum. Am J Surg Pathol 2000; 24: 688-93. 8. Ghai S, Pattison J, Ghai S, OMalley ME, Khalili K, Stephens M. Primary Gastrointestinal Lymphoma: Spectrum of Imaging Findings with Pathologic Correlation. RadioGraphics 2007; 27: 1371-1388. 11. Misdraji J, Fernandez del Castillo C, Ferry JA. Follicle center lymphoma of the ampulla of Vater presenting with jaundice: report of a case. Am J Surg Pathol 1997; 21: 484-8. 12. Sentani K, Maeshima AM, Nomoto J, Maruyama D, Kim S-M, Watanabe T, Kobayashi Y, Tobinai K, Matsuno Y. Follicular Lymphoma of the Duodenum: A Clinicopathologic Analysis of 26 Cases. Jpn J Clin Oncol 2008; 388: 547-552. 13. Goodlad JR, MacPherson S, Jackson R, Batstone P, White J. Extranodal follicular lymphoma: a clinicopathological and genetic analysis of 15 cases arising at non-cutaneous extranodal sites. Histopathology 2004; 44: 268-76. 14. Takata K, Sato Y, Nakamura N, Kikuti YY, Ichimura K, Tanaka T, Morito T, Tamura M, Oka T, Kondo E, Okada H, Tari A, Yoshino T. Duodenal and nodal follicular lymphomas are distinct: the former lacks activation-induced cytidine deaminase and follicular dendritic cells despite ongoing somatic hypermutations. Modern Pathology 2009; 22: 940-949. 15. Toyoda H, Yamaguchi M, Nakamura S, Nakamura T, Kimura M, Suzuki H, et al. Regression of primary lymphoma of the ampulla of Vater after eradication of Helicobacter pylori. Gastrointest Endosc 2001; 54: 92-6. 16. Rohatiner AZ, Davies A, Montoto S, Lister TA. Follicular Lymphoma Chapter 19 in: The lymphomas. Second edition. Elsevier Inc; 2006. p. 348-365.
Se presentó el caso de una paciente adulta mayor con un linfoma folicular primario duodenal, neoplasia infrecuente, de bajo grado, habitualmente diagnosticada incidentalmente en estados tempranos, por ello de buen pronóstico y cuyo aspecto endoscópico polipoide plantea diagnóstico diferencial con lesiones epiteliales y poliposis linfomatosa, entidades más frecuentes; su diagnóstico específico se establece por estudios histológico e inmunohistoquímico, excluyendo hiperplasia linfoide folicular reactiva y linfomas B, dentro de los cuales se destacan el compromiso gastrointestinal secundario por linfoma folicular ganglionar, el cual se presenta en estados avanzados, caracterizados además por adenopatías superficiales y toracoabdominales y los linfomas de la zona marginal y del manto poliposis linfomatosa primarios del tubo digestivo, también inusuales en el duodeno y cuyo comportamiento biológico y tratamiento difieren.