Aims:
A small intestine is a common involved site of malignant lymphomas. With the development
of double-balloon endoscopy (DBE), we can evaluate features and take biopsy from small
intestinal lymphomas (SIL) less invasively. We investigated the correlation between
endoscopic features and histological subtypes of SIL.
Methods:
We retrospectively analyzed 43 SIL patients diagnosed by using DBE at our institution
from April 2004 to September 2018.
Results:
The median age was 66 years (range 29 – 89 years) and 28 were males. Involved sites
included duodenum in 1 patient, jejunum in 18, ileum in 8 and broad small intestine
in 16. Histological subtypes were as follows; FL (N = 18), DLBCL (N = 17), MEITL (N
= 3), anaplastic large cell lymphoma (N = 2), adult T-cell leukemia-lymphoma (N =
1), extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue type (N
= 1), mantle cell lymphoma (N = 1). In Lugano classification, 18 patients were at
stage I, 6 at stage II1, 4 at stage II2, 5 at stage IIE, 10 at stage IV.
As regards endoscopic features, FL presented as mainly multiple lymphomatous polyposis
type (N = 16), DLBCL as ulcer type (N = 11), MEITL mixed type (N = 3).
*follicular lymphoma (FL), diffuse large B-cell lymphoma (DLBCL), monomorphic epitheliotropic
intestinal T-cell lymphoma (MEITL).
Conclusions:
There is a tendency between endoscopic features and histological subtypes. Pathological
grounds are needed for each definitive diagnosis, but we can predict a subtype of
malignant lymphoma based on endoscopic features. DBE is useful for diagnosis with
malignant lymphoma in terms of observation of morphologic features and pathological
and histological findings by biopsy.
