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(4): 1674-1683 [PMID: 26819532 DOI: 10.3748/wjg.v22.i4.1674]
Corresponding Author of This Article
Masaya Iwamuro, MD, Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-Ku, Okayama 700-8558, Japan. iwamuromasaya@yahoo.co.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Masaya Iwamuro, Eisei Kondo, Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
Masaya Iwamuro, Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
Katsuyoshi Takata, Tadashi Yoshino, Department of Pathology, 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
Author contributions: Iwamuro M organized the report and drafted the article; Kondo E, Takata K and Yoshino T critically revised the article for important intellectual content; Okada H approved the final article.
Conflict-of-interest statement: All of the authors declare that they have no conflicts of interest associated with this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Masaya Iwamuro, MD, Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-Ku, Okayama 700-8558, Japan. iwamuromasaya@yahoo.co.jp
Telephone: +81-86-2357219 Fax: +81-86-2255991
Received: July 22, 2015 Peer-review started: July 30, 2015 First decision: September 11, 2015 Revised: September 28, 2015 Accepted: October 12, 2015 Article in press: October 13, 2015 Published online: January 28, 2016 Processing time: 181 Days and 19.5 Hours
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.
Core tip: This review provides an overview regarding the initial diagnostic workup of gastrointestinal follicular lymphoma. 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. Although there is no doubt that endoscopic examinations play a major role in the diagnosis of this disease, gastroenterologists should also keep in mind that follicular lymphoma patients with gastrointestinal involvement must be investigated according to the general guidelines for systemic follicular lymphoma.
