Gastric Follicular Lymphomas Presenting as Subepithelial Tumors: Two Cases

Kim, Hyeong Jin; Choi, Cheol Woong; Park, Su Bum; Kim, Su Jin

doi:2018.18.4.258

Korean J Helicobacter Up Gastrointest Res > Volume 18(4); 2018 > Article

Case Report

The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2018;18(4):258-263.
DOI: https://doi.org/10.7704/kjhugr.2018.18.4.258 Published online December 10, 2018.

Gastric Follicular Lymphomas Presenting as Subepithelial Tumors: Two Cases

Hyeong Jin Kim

, Cheol Woong Choi

, Su Bum Park

, Su Jin Kim

Department of Internal Medicine, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea. drluckyace@gmail.com

위 상피하 종양으로 발견된 소포림프종 2예

김형진, 최철웅, 박수범, 김수진

부산대학교 의과대학 내과학교실, 양산부산대학교병원 의생명융합연구소

Correspondence: Cheol Woong Choi, Tel: +82-55-360-1535, Fax: +82-55-360-1536,
Email: drluckyace@gmail.com

Received: 18 July 2018 • Revised: 26 October 2018 • Accepted: 27 October 2018

Abstract

Follicular lymphoma is the most common form of low-grade B cell lymphoma. Follicular lymphoma occurs predominantly at lymph node sites and rarely in the gastrointestinal tract. Rare gastrointestinal follicular lymphoma is most commonly found in the small intestine, especially in the duodenum, and appears as multiple granules. However, gastric follicular lymphoma mostly appears as a subepithelial tumor. We observed two primary gastric follicular lymphomas that resembled subepithelial tumors located in the body of the stomach. Endoscopic ultrasound revealed hypoechoic lesions located in the submucosa layer. Since endoscopic forceps biopsies were inconclusive, we performed endoscopic submucosal dissection, which resulted in a final pathologic diagnosis of follicular lymphoma. Because of the indolent nature of gastrointestinal follicular lymphoma, the “watch and wait” strategy can be applied in the early phase. The identification of endoscopic characteristics of gastric follicular lymphoma can be helpful for differential diagnosis and decision of treatment strategy. Therefore, we report two cases of primary gastrointestinal follicular lymphoma diagnosed following endoscopic submucosal dissection.

Key Words: Endoscopic mucosal resection; Follicular lymphoma; Neoplasms