Clinical Gastroenterology Vol.12 No.4(7)

Theme Duodenal Tumors
Title Malignant Lymphoma of the Duodenum
Publish Date 1997/04
Author Takashi Kawai Department of Internal Medicine of Nagoya Municipal Johsai Hospital
[ Summary ] Malignant lymphoma of the duodenum is a rare disease. We describe the characteristic features of roentgenographic alterations, endoscopic observations, and histological findings of this disease. Differential diagnosis between malignant lymphoma and other duodenal lesions is also outlined. Because genetic engineering has made remarkable progress recently, the analysis of gene rearrangements is helpful for determining whether the lesion is malignant lymphoma or reactive lymphoid tissue. Recently, it has been proposed that there is a variable group of extranodal B-cell lymphomas which have in common an origin from mucosa-associated lymphoid tissue (MALT). The prognosis of duodenal lymphoma is poorer than that of lymphoma in other parts of the small intestine, primarily because of its anatomic location and advanced disease stage at initial presentation. However, in contrast to the poor prognosis of high-grade lymphomas, low-grade lymphomas like the MALT-derived lymphoma (MALToma) tend to remain localized and rarely involve the marrow. MALToma in the stomach has been intensively investigated, but in the duodenum it is so rare that its characteristic appearance has not been described in detail. In this paper, we also present a case of MALToma localized to the duodenal bulb with a distinctive appearance.
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