原发性肠道滤泡性淋巴瘤三例

Duodenal-type follicular lymphoma:a report of three cases

原发性肠道滤泡性淋巴瘤(D-FL)是一种罕见的疾病,目前其生物学特性和临床进展尚不清楚。该文报道了3例原发性肠道滤泡性淋巴瘤患者,平均年龄为51岁,均为体检时发现,2例患者无不适主诉,1例患者感上腹部不适伴乏力,入院后经完善CT及胃镜检查,最后均通过病理活检确诊。2例患者因无症状拒绝治疗,随访至今病情均未进展,1例患者予R2方案(奥妥珠单抗+来那度胺)化学治疗1年余,至截稿日患者有时感上腹部不适、乏力及夜间盗汗。该3例患者的诊治过程提示,D-FL生物学行为通常为惰性,无症状患者可考虑定期随访观察,对于有症状的年轻患者如患者同意可积极治疗。目前国内外尚无D-FL的诊治指南及共识,该文报道3例患者的诊治过程,以期拓宽临床医生对D-FL的诊治思路。

Duodenal-type follicular lymphoma(D-FL)is a rare disease.At present,biological characteristics and clinical progression of D-FL are still unclear.In this article,three patients with D-FLwere reported,with an average age of 51 years.All patients were diagnosed during physical examination.Two patients had no complaints,and one patient reported upper abdominal discomfort and fatigue.After admission,all patients underwent CT and gastroscopy,and the diagnosis of D-FL wasfinally confirmed by pathological biopsy.Two patients refused treatment because of no symptoms,and the disease did not progress during follow-up.One patient received R2 regimen(obinutuzumab+lenalidomide)chemotherapy for more than 1 year.Upon the submission date,heoccasionally felt epigastric discomfort,fatigue and night sweats.The diagnosis and treatment of these three patients suggest that biological behaviors of D-FL are constantly indolent.Regular follow-up observation can be considered for asymptomatic patients,and active treatment can be performed for symptomatic young patients if they accept.At present,there is no guideline or consensus on the diagnosis and treatment of D-FL at home and abroad.The diagnosis and treatment process of three patients are reported,aiming to deepen clinicians’understanding of diagnosis and treatment of D-FL.