Two Cases of Small Intestinal Follicular Lymphoma Presenting with Intestinal Stricture

TL;DR

This paper reports two rare cases of small intestinal follicular lymphoma causing intestinal stricture and managed with surgical resection.

Contribution

The novelty lies in highlighting the rare presentation of follicular lymphoma as a cause of intestinal stricture.

Findings

Surgical resection provided diagnostic confirmation and symptom relief in both patients.

Postoperative imaging showed no residual lymphoma in either case.

Patients were managed without chemotherapy based on individual assessments.

Abstract

Primary gastrointestinal follicular lymphoma (FL) rarely causes intestinal stricture. We report two cases of small intestinal FL presenting with stricture.

Case 1: A 63-year-old man presented with small intestinal obstruction. CT demonstrated ileal wall thickening and enlarged lymph nodes. Partial ileal resection confirmed primary ileal FL, immunohistochemically positive for CD10, CD20, and BCL-2. Case 2: A 79-year-old woman with a 7-year history of jejunal strictures underwent right hemicolectomy for ascending colon cancer and partial jejunal resection. Pathologic examination showed concurrent jejunal FL and colon adenocarcinoma. Immunohistochemical findings were the same as in Case 1. In both patients, postoperative positron-emission tomography-CT showed no residual lymphoma. Both were monitored clinically without chemotherapy.

These cases highlight an unusual presentation of follicular lymphoma as a cause of intestinal stricture. Surgical resection provided diagnostic clarity and relief of symptoms. Postoperative treatment was tailored to individual patient characteristics and residual disease status.

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