Follicular Lymphoma Involving the Small Intestine: Is There an Association with Gastric Disease or Helicobacter Pylori?
RN Miranda, T Muzzafar, LJ Medeiros. M.D. Anderson Cancer Center, Houston, TX
Background: Follicular lymphoma (FL) involving the small intestine is uncommon and its etiology is unknown. Rare case reports of FL of small intestine have shown an association with gastric Helicobacter pylori infection, and it has been suggested a pathogenic role (Gastrointest Endosc 2001; 54:92). In this study we evaluated the hypothesis that associated gastric disease or Helicobacter pylori infection might play a role in pathogenesis of FL of small intestine.
Design: We identified 23 patients who had FL involving the small intestine who also had simultaneously obtained stomach biopsy specimens at our institution over the past 10 years. Their clinicopathologic features are presented.
Results: The study group included 11 women and 12 men, with a median age of 60 years (range, 39 - 81). Three distinct groups were identified: Localized and presumably primary (n=7), disseminated (n=9) and patients with a history of FL (n=7). Lymphoma involved the duodenum (n=15), ileum (n=5), and jejunum (n=3). Histologically, the FL was low-grade in 22/23 cases; one patient with a history of FL had a grade 3 tumor. FL was simultaneously identified in the stomach of 7 (30%) patients: 1 of 7 (14%) localized, 2 of 9 (22%) disseminated, and 4 of 7 (57%) with a history of FL. Chronic active gastritis with Helicobacter organisms was identified in 4 patients: 2 (29%) localized, 1 (11%) disseminated, and 1 (14%) with a history of FL.
Conclusions: Patients with FL involving the small intestine who undergo biopsy are a heterogeneous group. There is no apparent association between the presence of chronic active gastritis or Helicobacter infection with FL involving the small intestine.
Tuesday, March 10, 2009 9:30 AM
Poster Session III # 143, Tuesday Morning