Small bowel (small intestine) - Follicular lymphoma

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Small bowel (small intestine)

Lymphoma

Follicular lymphoma

Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 22 December 2012, last major update August 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Common low grade lymphoma, often arises in terminal ileum or as small polypoid masses throughout bowel (lymphomatoid polyposis, which may also represent mantle cell lymphoma)
● Either primary or secondary

General-primary follicular lymphoma of small bowell
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● Median age 54 years, 2/3 female
● Small bowel is most common site in GI tract; duodenum > ileum > colon; often transmural involvement
● Disease localized to bowel and regional lymph nodes in most cases (Am J Surg Pathol 2011;35:1255)
● Indolent with occasional relapses but no/rare deaths, median disease free survival of 69 months (Am J Surg Pathol 2002;26:216)
● Duodenal cases may be more common in women, are usually periampullary (Am J Surg Pathol 2000;24:688)
● Distal small bowel involvement is more likely to present as bowel obstruction requiring resection

Gross description
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● Bowel thickening with multiple elevated nodules or plaques, possible bowel obstruction

Micro description
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● Usually follicular growth pattern of small, cleaved, bland appearing lymphocytes
● May transform to higher histologic grade

Micro images
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Various images

Positive stains
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● CD20, CD10, BCL2; also CD75, CD79

Negative stains
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● CD3, CD5, CD23, BCL1/Cyclin D1

Molecular description
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● t(14;18) in 80% (Cancer 2010 Dec 29. [Epub ahead of print])

Additional references
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● Hepatogastroenterology 2012;59:751, J Gastroenterol 2010;45:370, J Clin Gastroenterol 2008;42:997

End of Small bowel (small intestine) > Lymphoma > Follicular lymphoma

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