Case Report
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World J Gastroenterol. Mar 28, 2013; 19(12): 1992-1996
Published online Mar 28, 2013. doi: 10.3748/wjg.v19.i12.1992
Usefulness of positron emission tomography in primary intestinal follicular lymphoma
Akira Tari, Hideki Asaoku, Masaki Kunihiro, Shinji Tanaka, Tadashi Yoshino
Akira Tari, Masaki Kunihiro, Division of Gastroenterology, Department of Internal Medicine, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, Hiroshima 734-8551, Japan
Hideki Asaoku, Department of Clinical Laboratory, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, Hiroshima 734-8551, Japan
Shinji Tanaka, Department of Endoscopy, Hiroshima University Hospital, Hiroshima 734-8551, Japan
Tadashi Yoshino, Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8530, Japan
Author contributions: Tari A performed the endoscopic examination, diagnosed and decided treatment policy, analyzed the data and wrote the paper; Asaoku H performed the hematological examination, diagnosed and decided treatment policy; Kunihiro M performed the endoscopic examination and diagnosis; Tanaka S performed the double-balloon enteroscopy and diagnosis; and Yoshino T performed the pathological diagnosis.
Correspondence to: Dr. Akira Tari, Division of Gastroenterology, Department of Internal Medicine, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima 734-8551, Japan. stomach2@hiroshima-med.jrc.or.jp
Telephone: +81-82-2413111 Fax: +81-82-2460676
Received: November 20, 2012
Revised: December 25, 2012
Accepted: January 5, 2013
Published online: March 28, 2013
Processing time: 129 Days and 18.7 Hours
Abstract

Double-balloon enteroscopy (DBE) and video capsule endoscopy are useful for the diagnosis of lymphoma in the small intestine. However, DBE cannot be safely performed in cases with passage disturbance due to wall thickening and stenosis. Additionally, video capsule endoscopy cannot be performed in such cases because of the risk of retention. Here, we report 4 cases of primary follicular lymphoma of the gastrointestinal tract that could be detected using 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography (PET-CT). The endoscopic findings of these 4 cases included lesions with wall thickening, which comprised macroscopically clusters of nodules, dense clusters of whitish granules or small nodules, fold thickening and ulcers with irregular margins that occupied the whole lumen with edematous mucosa. All patients fulfilled the World Health Organization grade 1 criteria. 18F-fluorodeoxyglucose PET-CT can help predict the risks that may result from certain endoscopic examinations, such as DBE and video capsule endoscopy.

Keywords: Capsule endoscopy; Double-balloon enteroscopy; Follicular lymphoma; Positron-emission tomography; Computed tomography; Small intestine