Four types of duodenal white lesions (follicular lymphoma, lymphoid hyperplasia, lymphangiectasia, and lymphangioma) : A case report

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  • Iwamuro Masaya
    Department of Gastroenterology, Okayama University Hospital
  • Tanaka Takehiro
    Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • Okada Hiroyuki
    Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

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  • 十二指腸に濾胞性リンパ腫，リンパ濾胞過形成，リンパ管腫およびリンパ管拡張を合併した１例
  • ジュウニシチョウ ニ ロホウセイ リンパシュ,リンパ ロホウ カケイセイ,リンパカン シュ オヨビ リンパカン カクチョウ オ ガッペイ シタ 1レイ

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A 70-year-old Japanese man underwent esophagogastroduodenoscopy that revealed multiple whitish duodenal granules. The histopathological analysis of the biopsied specimen led to the diagnosis of duodenal-type follicular lymphoma. The lesion showed spontaneous improvement ; however, 14 months later a few small whitish granules were observed by esophagogastroduodenoscopy. Observation under magnification revealed slightly elevated opaque white spots and whitish granular protrusions of roughly the same size that were uniformly distributed in the duodenal bulb. The duodenal bulb lesions were histopathologically diagnosed as lymphoid hyperplasia. The patient also exhibited lymphangiectasia (which presented as scattered white spots) and lymphangioma (which presented as a soft submucosal tumor with white spots on the surface) in the second portion of the duodenum. This patient presented with four white lesions in the duodenum : duodenal-type follicular lymphoma, lymphoid hyperplasia, lymphangiectasia, and lymphangioma. Careful endoscopic evaluation enabled a prompt diagnosis in this case.

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