Pathogenesis of Gastrointestinal Follicular Lymphomas: Consideration Based on Histopathology and Endoscopic Findings.

Autor:	Takahashi Y; Departments of Diagnostic Pathology., Taniguchi H; Departments of Diagnostic Pathology.; Pathology and Clinical Laboratory, JR Tokyo General Hospital., Haruhi F; Department of Hematology., Hattori D; Department of Hematology., Sasaki H; Department of Hematology., Makita S; Department of Hematology., Iwaki N; Department of Hematology., Fukuhara S; Department of Hematology., Munakata W; Department of Hematology., Saito Y; Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan., Izutsu K; Department of Hematology., Maeshima AM; Departments of Diagnostic Pathology.
Jazyk:	angličtina
Zdroj:	The American journal of surgical pathology [Am J Surg Pathol] 2023 Oct 01; Vol. 47 (10), pp. 1134-1143. Date of Electronic Publication: 2023 Jul 27.
DOI:	10.1097/PAS.0000000000002095
Abstrakt:	Gastrointestinal (GI) follicular lymphoma (FL) is the most frequently diagnosed extranodal FL; however, its pathogenesis is debatable. We investigated the distribution, endoscopic, and histopathologic findings of 366 GI FL samples obtained from 298 patients. FLs were most frequently observed in the small intestine (71%), including the duodenum (52%), but were also commonly found in the stomach (15%) and colon (12%). The proportion of granular lesions in the duodenum, terminal ileum, colon, and stomach was 74%, 39%, 24%, and 0%, respectively. Submucosal or ulcerated tumors were frequently observed in the stomach (48%) and colon (52%). Most GI FL showed grade 1 to 2 histology (89%) as well as CD10 + (93%) and BCL2 + (98%) positivity. There were no significant differences in the endoscopic or histologic findings between primary and secondary GI FLs. As known, the mucosa of the small intestine is thin and villous, while the mucosa of the stomach and colon is thicker and has a smooth surface. Granular lesions corresponding to very small FL were detected in the former but rarely in the latter. Nine (7%) patients with primary GI FL developed histologic transformation to diffuse large B-cell lymphoma (n=8) or high-grade B-cell lymphoma (n=1) 10 months to 14 years after the diagnosis of FL. Two patients died of lymphoma. In conclusion, the incidence and endoscopic findings differed, but the histopathology was similar in FLs in each site. These differences might be attributed to variations in each GI site's mucosal structure and the neoplastic follicles' size. Due to its characteristic structure, very small classic FLs might be detectable mainly in the small intestine. Competing Interests: Conflicts of Interest and Source of Funding: This work was partly supported by the Japan Agency for Medical Research and Development Fund (grant number 22ck0106670h0002). The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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