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Klimza H, Maćkowiak B, Zagaja K, Jackowska J, Banaszewski J, Wierzbicka M. The usefulness of narrow-band Imaging (NBI) in nasopharyngeal lesions-Validation of the Ni NBI classification dedicated for vascular pattern in the nasopharynx. PLoS One 2024; 19:e0302043. [PMID: 38885230 PMCID: PMC11182514 DOI: 10.1371/journal.pone.0302043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 03/27/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND This study aims to explore the applicability of narrow-band imaging (NBI) involving the Ni classification for the diagnosis of nasopharyngeal mucosal lesions in order to distinguish malignant tumours (NPT) from non-malignant lesions. METHODS Each patient (n = 53) with a suspected nasopharyngeal lesion underwent a trans-nasal flexible video endoscopy with an optical filter for NBI. We assessed the suspected area using white light imaging (WLI) in terms of location and morphology as well as the vascular pattern (using Ni classification of nasopharyngeal microvessels) and surrounding tissue by using NBI. Based on the results of the NBI and WLI, patients were classified into "positive" or "negative" groups. All lesions of the nasopharynx were biopsied and submitted for final histological evaluation. RESULTS NBI showed higher sensitivity, specificity, and accuracy than WLI. There was a significant correlation between the final histological result and the NBI pattern of the NPT: Chi2(1) = 31.34; p = 0.000001 and the WLI assessment of the NPT: Chi2(1) = 14.78; p = 0.00012. CONCLUSIONS The assessment of the NPT in NBI using Ni NBI classification proved valuable in suspected mucosa assessment. NBI not only confirms the suspicious areas in WLI, but it also shows microlesions beyond the scope of WLI and allows for proper sampling.
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Affiliation(s)
- Hanna Klimza
- Regional Specialist Hospital Wroclaw, Research & Development Centre, Wrocław, Poland
| | - Bartosz Maćkowiak
- Department of Otolaryngology, Poznan University of Medical Sciences, Poznan, Poland
| | - Kacper Zagaja
- Department of Otolaryngology, Poznan University of Medical Sciences, Poznan, Poland
| | - Joanna Jackowska
- Department of Otolaryngology, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Banaszewski
- Department of Otolaryngology, Poznan University of Medical Sciences, Poznan, Poland
| | - Małgorzata Wierzbicka
- Regional Specialist Hospital Wroclaw, Research & Development Centre, Wrocław, Poland
- Institute of Human Genetics, Polish Academy of Sciences, Poznań, Poland
- Wroclaw University of Science and Technology, Wroclaw, Poland
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Yeh P, Li TY, Cheng PW. Narrow-band imaging for detecting nasal lymphoma. Photodiagnosis Photodyn Ther 2022; 41:103197. [PMID: 36368449 DOI: 10.1016/j.pdpdt.2022.103197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/07/2022] [Accepted: 11/07/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Narrow-band imaging (NBI) is an advanced endoscopic technique that enhances the mucosal neovascularization. The utilization of narrow-band imaging on the detection of nasal lymphomas is not well-established. AIM To present a clinical case whose nasal lymphoma was detected with the aid of NBI. CASE REPORT A 91-year-old male presented to the ear, nose, and throat clinic with right persisting nasal obstruction for 4 months. NBI revealed a well demarcated lesion with an elongated vessel on the surface of the right inferior nasal turbinate. Histopathologic analysis of tissue specimen proved to be extranodal NK/T-cell lymphoma, nasal type. CONCLUSIONS NBI is useful for the detection of nasal lymphomas. NBI may be a valuable screening tool for nasal lymphomas as it is non-invasive and affordable.
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Affiliation(s)
- Peng Yeh
- Department of Otolaryngology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Tzu-Yu Li
- Department of Otolaryngology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Po-Wen Cheng
- Department of Otolaryngology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
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Horie T, Hosoe N, Takabayashi K, Hayashi Y, Kamiya KJLL, Miyanaga R, Mizuno S, Fukuhara K, Fukuhara S, Naganuma M, Shimoda M, Ogata H, Kanai T. Endoscopic characteristics of small intestinal malignant tumors observed by balloon-assisted enteroscopy. World J Gastrointest Endosc 2019; 11:373-382. [PMID: 31205598 PMCID: PMC6556486 DOI: 10.4253/wjge.v11.i5.373] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 05/11/2019] [Accepted: 05/13/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Capsule endoscopy and balloon-assisted enteroscopy (BAE) enable visualization of rare small bowel conditions such as small intestinal malignant tumors. However, details of the endoscopic characteristics of small intestinal malignant tumors are still unknown. AIM To elucidate the endoscopic characteristics of small intestinal malignant tumors. METHODS From March 2005 to February 2017, 1328 BAE procedures were performed at Keio University Hospital. Of these procedures, malignant tumors were classified into three groups, Group 1: epithelial tumors including primary small intestinal cancer, metastatic small intestinal cancer, and direct small intestinal invasion by an adjacent organ cancer; Group 2: small intestinal malignant lymphoma; and Group 3, small intestinal gastrointestinal stromal tumors. We systematically collected clinical and endoscopic data from patients' medical records to determine the endoscopic characteristics for each group. RESULTS The number of patients in each group was 16 (Group 1), 22 (Group 2), and 6 (Group 3), and the percentage of solitary tumors was 100%, 45.5%, and 100%, respectively (P < 0.001). Patients' clinical background parameters including age, symptoms, and laboratory data were not significantly different between the groups. Seventy-five percent of epithelial tumors (Group 1) were located in the upper small intestine (duodenum and ileum), and approximately 70% of gastrointestinal stromal tumors (Group 3) were located in the jejunum. Solitary protruding or mass-type tumors were not seen in malignant lymphoma (Group 2) (P < 0.001). Stenosis was seen more often in Group 1, (68.8%, 27.3%, and 0%; Group 1, 2, and 3, respectively; P = 0.004). Enlarged white villi inside and/or surrounding the tumor were seen in 12.5%, 54.5%, and 0% in Group 1, 2, and 3, respectively (P = 0.001). CONCLUSION The differential diagnosis of small intestinal malignant tumors could be tentatively made based on BAE findings.
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Affiliation(s)
- Tomofumi Horie
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo 160-8582, Japan
| | - Naoki Hosoe
- Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University, Tokyo 160-8582, Japan
| | - Kaoru Takabayashi
- Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University, Tokyo 160-8582, Japan
| | - Yukie Hayashi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo 160-8582, Japan
| | - Kenji JL Limpias Kamiya
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo 160-8582, Japan
| | - Ryoichi Miyanaga
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo 160-8582, Japan
| | - Shinta Mizuno
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo 160-8582, Japan
| | - Kayoko Fukuhara
- Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University, Tokyo 160-8582, Japan
| | - Seiichiro Fukuhara
- Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University, Tokyo 160-8582, Japan
| | - Makoto Naganuma
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo 160-8582, Japan
| | - Masayuki Shimoda
- Department of Pathology, School of Medicine, Keio University, Tokyo 160-8582, Japan
| | - Haruhiko Ogata
- Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University, Tokyo 160-8582, Japan
| | - Takanori Kanai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo 160-8582, Japan
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Takahashi K, Bamba S, Kawahara M, Nishida A, Inatomi O, Sasaki M, Tsujikawa T, Kushima R, Sugimoto M, Kitoh K, Andoh A. Magnified single-balloon enteroscopy in the diagnosis of intestinal follicular lymphoma: a case series. Intest Res 2018; 16:628-634. [PMID: 30301328 PMCID: PMC6223446 DOI: 10.5217/ir.2018.00003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 04/30/2018] [Indexed: 12/19/2022] Open
Abstract
The objective of this study was to evaluate the magnified endoscopic findings in the diagnosis of follicular lymphoma in the small intestine in comparison with those of intestinal follicular lymphoma and lymphangiectasia. Four patients with follicular lymphoma and 3 with lymphangiectasia in the small intestine were retrospectively analyzed. A prototype magnifying singleballoon enteroscope was used. The findings of the intestinal follicular lymphoma and lymphangiectasia were retrospectively analyzed to determine the magnified endoscopic findings of follicular lymphoma in the small intestine. Opaque white granules were observed in 3 of the 4 patients with follicular lymphoma. Magnified narrow-band imaging (NBI) of the opaque white granules showed stretched microvessels, which had a diminutive tree-like appearance. The remaining patient had no opaque white granules and only displayed whitish villi. Magnified NBI observation of the whitish villi revealed the absence of marginal villus epithelium, which was confirmed by histology. The magnified NBI enteroscopy revealed the diminutive tree-like appearance on the opaque white granules and the absence of marginal villus epithelium of the whitish villi in intestinal follicular lymphoma. These findings may be useful in diagnosing follicular lymphoma.
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Affiliation(s)
| | - Shigeki Bamba
- Division of Clinical Nutrition, Shiga University of Medical Science, Otsu, Japan
| | - Masahiro Kawahara
- Department of Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Atsushi Nishida
- Department of Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Osamu Inatomi
- Department of Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Masaya Sasaki
- Division of Clinical Nutrition, Shiga University of Medical Science, Otsu, Japan
| | - Tomoyuki Tsujikawa
- Department of Comprehensive Internal Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Ryoji Kushima
- Division of Diagnostic Pathology, Shiga University of Medical Science, Otsu, Japan
| | - Mitsushige Sugimoto
- Division of Digestive Endoscopy, Shiga University of Medical Science, Otsu, Japan
| | - Katsuyuki Kitoh
- Department of Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Akira Andoh
- Department of Medicine, Shiga University of Medical Science, Otsu, Japan
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Harada A, Oguchi M, Terui Y, Takeuchi K, Igarashi M, Kozuka T, Harada K, Uno T, Hatake K. Radiation therapy for localized duodenal low-grade follicular lymphoma. JOURNAL OF RADIATION RESEARCH 2016; 57:412-417. [PMID: 27009323 PMCID: PMC4973641 DOI: 10.1093/jrr/rrw011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 01/12/2016] [Accepted: 01/15/2016] [Indexed: 06/05/2023]
Abstract
The aim of this study was to evaluate the initial treatment results and toxicities of radiation therapy for patients with early stage low-grade follicular lymphoma (FL) arising from the duodenum. We reviewed 21 consecutive patients with early stage duodenal FL treated with radiation therapy between January 2005 and December 2013 at the Cancer Institute Hospital, Tokyo. The characteristics of patients were: median age 62 years (range, 46-79 years), gender (male, 6; female, 15), clinical stage (I, 20; II1, 1), histological grade (I, 17; II, 4). All patients were treated with radiation therapy alone. The median radiation dose was 30.6 Gy (range, 30.6-39.6) in 17 fractions. The involved-site radiation therapy was delivered to the whole duodenum. The median follow-up time was 43.2 months (range 21.4-109.3). The 3-year overall survival (OS), relapse-free survival (RFS) and local control (LC) rates were 94.7%, 79.3% and 100%, respectively. There were four relapses documented outside the treated volumes: two in the gastrointestinal tract (jejunum, terminal ileum), one in an abdominal lymph node (mesenteric lymph node) and one in the bone marrow. None died of the disease; one death was due to acute myeloid leukemia. No toxicities greater than Grade 1 were observed during treatment and over the follow-up time. The 30.6 Gy of involved-site radiation therapy provided excellent local control with very low toxicities. Radiation therapy could be an effective and safe treatment option for patients with localized low grade FL arising from the duodenum.
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Affiliation(s)
- Arisa Harada
- Radiation Oncology Department, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Ariake, Kouto-ku, Tokyo 135-8550, Japan
| | - Masahiko Oguchi
- Radiation Oncology Department, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Ariake, Kouto-ku, Tokyo 135-8550, Japan
| | - Yasuhito Terui
- Hematology Oncology Department, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Ariake, Kouto-ku, Tokyo 135-8550, Japan
| | - Kengo Takeuchi
- Pathology Department, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Ariake, Kouto-ku, Tokyo 135-8550, Japan
| | - Masahiro Igarashi
- Endoscopy Department, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Ariake, Kouto-ku, Tokyo 135-8550, Japan
| | - Takuyo Kozuka
- Radiation Oncology Department, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Ariake, Kouto-ku, Tokyo 135-8550, Japan
| | - Ken Harada
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Takashi Uno
- Department of Radiation Oncology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Kiyohiko Hatake
- Hematology Oncology Department, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Ariake, Kouto-ku, Tokyo 135-8550, Japan
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Iwamuro M, Kondo E, Takata K, Yoshino T, Okada H. Diagnosis of follicular lymphoma of the gastrointestinal tract: A better initial diagnostic workup. World J Gastroenterol 2016; 22:1674-83. [PMID: 26819532 PMCID: PMC4721998 DOI: 10.3748/wjg.v22.i4.1674] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 09/28/2015] [Accepted: 10/12/2015] [Indexed: 02/06/2023] Open
Abstract
Due to an increasing incidence and more frequent recognition by endoscopists, gastrointestinal follicular lymphoma has been established as a variant of follicular lymphoma. However, due to its rarity, there are no established guidelines on the optimal diagnostic strategy for patients with primary gastrointestinal follicular lymphoma or secondary gastrointestinal involvement of systemic follicular lymphoma. This review offers an overview and pitfalls to avoid during the initial diagnostic workup of this disease entity. Previously reported case reports, case series, and retrospective studies are reviewed and focus on the disease's endoscopic and histological features, the roles of computed tomography and positron emission tomography scanning, the clinical utility of the soluble interleukin-2 receptor, and the possible pathogenesis.
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Dutta AK, Chacko A. Emerging role of narrow band imaging in duodenum. World J Gastrointest Endosc 2015; 7:1216-1221. [PMID: 26566428 PMCID: PMC4639743 DOI: 10.4253/wjge.v7.i16.1216] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Revised: 08/20/2015] [Accepted: 09/30/2015] [Indexed: 02/05/2023] Open
Abstract
Endoscopy using magnification narrow band imaging (mNBI) allows detailed assessment of mucosal surface and vascular pattern. This may help in better identification and prediction of the nature of the lesion. The role of this technology in duodenum is still evolving. Studies have shown that mNBI has high accuracy in predicting villous atrophy in the duodenum. Limited data suggests that this technique can provide additional information on duodenal polyps, nodules and ampullary tumour which can help guide their management. In this paper we describe the technique for duodenal assessment using NBI and review the existing literature evaluating its role in diagnosis of various duodenal pathologies.
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Vetro C, Bonanno G, Giulietti G, Romano A, Conticello C, Chiarenza A, Spina P, Coppolino F, Cunsolo R, Raimondo FD. Rare gastrointestinal lymphomas: The endoscopic investigation. World J Gastrointest Endosc 2015; 7:928-949. [PMID: 26265987 PMCID: PMC4530327 DOI: 10.4253/wjge.v7.i10.928] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 06/01/2015] [Accepted: 07/09/2015] [Indexed: 02/05/2023] Open
Abstract
Gastrointestinal lymphomas represent up to 10% of gastrointestinal malignancies and about one third of non-Hodgkin lymphomas. The most prominent histologies are mucosa-associated lymphoid tissue lymphoma and diffuse large B-cell lymphoma. However, the gastrointestinal tract can be the site of rarer lymphoma subtypes as a primary or secondary localization. Due to their rarity and the multifaceted histology, an endoscopic classification has not been validated yet. This review aims to analyze the endoscopic presentation of rare gastrointestinal lymphomas from disease diagnosis to follow-up, according to the involved site and lymphoma subtype. Existing, new and emerging endoscopic technologies have been examined. In particular, we investigated the diagnostic, prognostic and follow-up endoscopic features of T-cell and natural killer lymphomas, lymphomatous polyposis and mantle cell lymphoma, follicular lymphoma, plasma cell related disease, gastrointestinal lymphomas in immunodeficiency and Hodgkin’s lymphoma of the gastrointestinal tract. Contrarily to more frequent gastrointestinal lymphomas, data about rare lymphomas are mostly extracted from case series and case reports. Due to the data paucity, a synergism between gastroenterologists and hematologists is required in order to better manage the disease. Indeed, clinical and prognostic features are different from nodal and extranodal or the bone marrow (in case of plasma cell disease) counterpart. Therefore, the approach should be based on the knowledge of the peculiar behavior and natural history of disease.
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IWAMURO MASAYA, OKADA HIROYUKI, KAWANO SEIJI, SHIODE JUNJI, TAKENAKA RYUTA, IMAGAWA ATSUSHI, INABA TOMOKI, SUZUKI SEIYU, NISHIMURA MAMORU, MIZUNO MOTOWO, ARAKI MASASHI, MANNAMI TOMOHIKO, UEKI TORU, KOBASHI HARUHIKO, FUKATSU HARUKA, TANAKA SHOUICHI, OMOTO AKIYOSHI, KAWAI YOSHINARI, KITAGAWA TAKASHI, TOYOKAWA TATSUYA, TAKATA KATSUYOSHI, YOSHINO TADASHI, TAKAKI AKINOBU, YAMAMOTO KAZUHIDE. A multicenter survey of enteroscopy for the diagnosis of intestinal follicular lymphoma. Oncol Lett 2015; 10:131-136. [PMID: 26170988 PMCID: PMC4486797 DOI: 10.3892/ol.2015.3251] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 04/27/2015] [Indexed: 12/19/2022] Open
Abstract
The importance of enteroscopy examinations to investigate the entire length of the small intestines has been emphasized in follicular lymphoma patients with intestinal involvement. The aim of the present study was to determine the current state of enteroscopy examinations, including the performance rate, and the prevalence of small intestinal lesions in a patient population in Japan. A retrospective multicenter survey of 17 institutions collected the case information of 110 follicular lymphoma patients with gastrointestinal involvement. The results of the enteroscopy examinations were reviewed, and in order to identify potential factors affecting the performance rate of enteroscopy, patient gender, age at lymphoma diagnosis, histopathological grade, clinical stage, the date of the initial diagnosis and the annual volume of enteroscopy at the institution were compared between the patients who underwent one or more enteroscopy procedures and the patients who did not undergo enteroscopy. A total of 34 patients (30.9%) underwent enteroscopy, and 24 of these (70.6%) presented with involvement in the jejunum and/or ileum. It was found that more patients diagnosed in recent years and more patients treated at an ultra-high volume institution (≥101 enteroscopy examinations/year) underwent an enteroscopy. In conclusion, although the prevalence of small intestinal lesions was high (70.6%) in the follicular lymphoma patients presenting with intestinal involvement, the performance rate of enteroscopy was only 30.9%, and thus the majority of the patients have not undergone enteroscopy examinations. Further investigation is required to define the clinical significance of enteroscopy at the initial diagnostic work-up and during the follow-up period of these patients.
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Affiliation(s)
- MASAYA IWAMURO
- Department of Molecular Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - HIROYUKI OKADA
- Department of Endoscopy, Okayama University Hospital, Okayama 700-8558, Japan
| | - SEIJI KAWANO
- Department of Endoscopy, Okayama University Hospital, Okayama 700-8558, Japan
| | - JUNJI SHIODE
- Department of Internal Medicine, Okayama Saiseikai General Hospital, Okayama 700-8511, Japan
| | - RYUTA TAKENAKA
- Department of Internal Medicine, Tsuyama Chuo Hospital, Tsuyama 708-0841, Japan
| | - ATSUSHI IMAGAWA
- Department of Gastroenterology, Mitoyo General Hospital, Kanonji 769-1695, Japan
| | - TOMOKI INABA
- Department of Gastroenterology, Kagawa Prefectural Central Hospital, Takamatsu 760-8557, Japan
| | - SEIYU SUZUKI
- Department of Internal Medicine, Sumitomo Besshi Hospital, Niihama 792-8543, Japan
| | - MAMORU NISHIMURA
- Department of Internal Medicine, Okayama City Hospital, Okayama 700-8557, Japan
| | - MOTOWO MIZUNO
- Department of Internal Medicine, Hiroshima City Hospital, Hiroshima 730-8518, Japan
| | - MASASHI ARAKI
- Department of Internal Medicine, Kagawa Rosai Hospital, Marugame 763-8502, Japan
| | - TOMOHIKO MANNAMI
- Department of Internal Medicine, Chugoku Central Hospital, Fukuyama 720-0001, Japan
| | - TORU UEKI
- Department of Internal Medicine, Fukuyama City Hospital, Fukuyama 721-8511, Japan
| | - HARUHIKO KOBASHI
- Department of Hepatology, Japanese Red Cross Okayama Hospital, Okayama 700-8607, Japan
| | - HARUKA FUKATSU
- Department of Internal Medicine, St. Mary's Hospital, Himeji 670-0801, Japan
| | - SHOUICHI TANAKA
- Department of Gastroenterology, Iwakuni Clinical Center, Iwakuni 740-8510, Japan
| | - AKIYOSHI OMOTO
- Department of Internal Medicine, Ako Central Hospital, Ako 678-0241, Japan
| | - YOSHINARI KAWAI
- Department of Gastroenterology, Onomichi Municipal Hospital, Onomichi 722-8503, Japan
| | - TAKASHI KITAGAWA
- Department of Surgery, Kitagawa Hospital, Okayama 709-0497, Japan
| | - TATSUYA TOYOKAWA
- Department of Gastroenterology, Fukuyama Medical Center, Fukuyama 720-8520, Japan
| | - KATSUYOSHI TAKATA
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - TADASHI YOSHINO
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - AKINOBU TAKAKI
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - KAZUHIDE YAMAMOTO
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
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Iwamuro M, Okada H, Takata K, Fujii N, Kawano S, Kawahara Y, Yoshino T, Yamamoto K. Magnifying Endoscopic Observation of Duodenal Involvement of Follicular Lymphoma before and after Chemotherapy. Intern Med 2015; 54:1741-5. [PMID: 26179528 DOI: 10.2169/internalmedicine.54.4390] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
A 60-year-old Japanese man was diagnosed with systemic follicular lymphoma with duodenal, jejunal, and ileal involvement. The duodenal lesion showed typical endoscopic features with multiple whitish granules. Chemotherapy with bendamustine and rituximab was administered, and complete remission was confirmed by CT scanning and positron emission tomography scanning. Although the duodenal granular lesions did not completely disappear, magnifying observation for the remaining lesions showed no evidence of residual lymphoma. Complete remission was pathologically confirmed by biopsy examinations. This case suggests the usefulness of magnifying observation in evaluating the effects of treatment for duodenal follicular lymphoma lesions.
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Affiliation(s)
- Masaya Iwamuro
- Department of Molecular Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
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11
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Iwamuro M, Shinagawa K, Okada H, Takata K, Yoshino T, Yamamoto K. Elevated soluble IL-2 receptor levels correlate with tumor bulk of follicular lymphomas with intestinal involvement. Clin Biochem 2013; 47:191-5. [PMID: 24362271 DOI: 10.1016/j.clinbiochem.2013.11.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 11/12/2013] [Accepted: 11/27/2013] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Establish a correlation between serum soluble interleukin 2 receptor (sIL-2R) levels and clinical characteristics of follicular lymphoma patients with gastrointestinal involvement. DESIGN AND METHODS Patients (n=44) presenting with follicular lymphoma lesions in the gastrointestinal tract were enrolled into the study and divided into 2 groups based on sIL-2R levels (normal vs. elevated). Clinical characteristics were also analyzed between groups. RESULTS Patients with elevated sIL-2R levels likely had systemic follicular lymphoma involvement (Ann Arbor system staging IIIES/IV or Lugano system staging II-2/IV), involvement of 5 or more nodal areas, and presentation of bulky tumors in the gastrointestinal tract. These patients also presented a high Follicular Lymphoma International Prognostic Index (FLIPI) score, suggestive of poor prognosis. No differences were found among other clinical characteristics including sex, age at lymphoma diagnosis, histological grade, LDH levels, bone marrow involvement, hemoglobin levels, and identification of tracer accumulation in gastrointestinal lesions by positron-emission tomography scanning. CONCLUSIONS sIL-2R levels can be used as an independent prognostic index in follicular lymphoma patients based on the correlation with the FLIPI score. Moreover, since high sIL-2R levels were associated with a large tumor bulk, sIL-2R may serve as a good indicator for monitoring disease relapse or progression.
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Affiliation(s)
- Masaya Iwamuro
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-Cho, Kita-Ku, Okayama 700-8558, Japan.
| | - Katsuji Shinagawa
- Department of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-Cho, Kita-Ku, Okayama 700-8558, Japan
| | - Hiroyuki Okada
- Department of Endoscopy, Okayama University Hospital, 2-5-1 Shikata-Cho, Kita-Ku, Okayama 700-8558, Japan
| | - Katsuyoshi Takata
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-Cho, Kita-Ku, Okayama 700-8558, Japan
| | - Tadashi Yoshino
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-Cho, Kita-Ku, Okayama 700-8558, Japan
| | - Kazuhide Yamamoto
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-Cho, Kita-Ku, Okayama 700-8558, Japan
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Iwamuro M, Okada H, Takata K, Shinagawa K, Fujiki S, Shiode J, Imagawa A, Araki M, Morito T, Nishimura M, Mizuno M, Inaba T, Suzuki S, Kawai Y, Yoshino T, Kawahara Y, Takaki A, Yamamoto K. Diagnostic role of 18F-fluorodeoxyglucose positron emission tomography for follicular lymphoma with gastrointestinal involvement. World J Gastroenterol 2012; 18:6427-p.6434. [PMID: 23197888 PMCID: PMC3508637 DOI: 10.3748/wjg.v18.i44.6427] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Revised: 08/29/2012] [Accepted: 09/12/2012] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the capacity for 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) to evaluate patients with gastrointestinal lesions of follicular lymphoma. METHODS This retrospective case series consisted of 41 patients with follicular lymphoma and gastrointestinal involvement who underwent 18F-FDG-PET and endoscopic evaluations at ten different institutions between November 1996 and October 2011. Data for endoscopic, radiological, and biological examinations performed were retrospectively reviewed from clinical records. A semi-quantitative analysis of 18F-FDG uptake was performed for each involved area by calculating the maximum standardized uptake value (SUVmax). Based on the positivity of 18F-FDG uptake in the gastrointestinal lesions analyzed, patients were subdivided into two groups. To identify potential predictive factors for 18F-FDG positivity, these two groups were compared with respect to gender, age at diagnosis of lymphoma, histopathological grade, pattern of follicular dendritic cells, mitotic rate, clinical stage, soluble interleukin-2 receptor levels detected by 18F-FDG-PET, lactate dehydrogenase (LDH) levels, hemoglobin levels, bone marrow involvement, detectability of gastrointestinal lesions by computed tomography (CT) scanning, and follicular lymphoma international prognostic index (FLIPI) risk. RESULTS Involvement of follicular lymphoma in the stomach, duodenum, jejunum, ileum, cecum, colon, and rectum was identified in 1, 34, 6, 3, 2, 3, and 6 patients, respectively. No patient had esophageal involvement. In total, 19/41 (46.3%) patients exhibited true-positive 18F-FDG uptake in the lesions present in their gastrointestinal tract. In contrast, false-negative 18F-FDG uptake was detected in 24 patients (58.5%), while false-positive 18F-FDG uptake was detected in 5 patients (12.2%). In the former case, 2/19 patients had both 18F-FDG-positive lesions and 18F-FDG-negative lesions in the gastrointestinal tract. In patients with 18F-FDG avidity, the SUVmax value of the involved gastrointestinal tract ranged from 2.6 to 17.4 (median: 4.7). For the 18F-FDG-negative (n = 22) and -positive (n = 19) groups, there were no differences in the male to female ratios (10/12 vs 4/15, P = 0.186), patient age (63.6 ± 2.4 years vs 60.1 ± 2.6 years, P = 0.323), presence of histopathological grade 1 vs 2 (20/2 and 17/2, P = 1.000), follicular dendritic cell pattern (duodenal/nodal: 13/5 vs 10/3, P = 1.000), mitotic rate (low/partly high, 14/1 vs 10/3, P = 0.311), clinical stage according to the Ann Arbor system (stages IE and IIE/other, 15/7 vs 15/4, P = 0.499), clinical stage according to the Lugano system (stages I and II-1/other, 14/8 vs 14/5, P = 0.489), soluble interleukin-2 receptor levels (495 ± 78 vs 402 ± 83, P = 0.884), LDH levels (188 ± 7 vs 183 ± 8, P = 0.749), hemoglobin levels (13.5 ± 0.3 vs 12.8 ± 0.4, P = 0.197), bone marrow involvement (positive/negative, 1/8 vs 1/10, P = 1.000), detectability by CT scanning (positive/negative, 1/16 vs 4/13, P = 0.335), and FLIPI risk (low risk/other, 16/6 vs 13/6, P = 0.763), respectively in each case. CONCLUSION These findings indicate that it is not feasible to predict 18F-FDG-avidity. Therefore, 18F-FDG-PET scans represent a complementary modality for the detection of gastrointestinal involvements in follicular lymphoma patients, and surveillance of the entire gastrointestinal tract by endoscopic examinations is required.
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