# Two Cases of Small Intestinal Follicular Lymphoma Presenting with Intestinal Stricture

**Authors:** Akihiro Nakamura, Syuichi Komori, So Murai, Shiori Shibata, Hideyuki Oyama, Kazuhiro Kijima, Yoshikuni Harada, Gaku Kigawa, Takahiro Umemoto, Takafumi Ogawa, Kuniya Tanaka

PMC · DOI: 10.70352/scrj.cr.25-0108 · 2025-06-18

## 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.

## Key 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.

## Linked entities

- **Proteins:** MME (membrane metalloendopeptidase), MS4A1 (membrane spanning 4-domains A1), BCL2 (BCL2 apoptosis regulator)
- **Diseases:** follicular lymphoma (MONDO:0018906), colon adenocarcinoma (MONDO:0002271)

## Full-text entities

- **Genes:** BCL2 (BCL2 apoptosis regulator) [NCBI Gene 596] {aka Bcl-2, PPP1R50}, MME (membrane metalloendopeptidase) [NCBI Gene 4311] {aka CALLA, CD10, CMT2T, NEP, SCA43, SFE}, KRT20 (keratin 20) [NCBI Gene 54474] {aka CD20, CK-20, CK20, K20, KRT21}
- **Diseases:** FL (MESH:D008224), ascending colon cancer (MESH:D015179), lymphoma (MESH:D008223), Intestinal Stricture (MESH:D003251), jejunal strictures (MESH:D007579), intestinal obstruction (MESH:D007415), colon adenocarcinoma (MESH:D003110)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

5 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12183004/full.md

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Source: https://tomesphere.com/paper/PMC12183004