Open Access

Gastric follicular lymphoma: A report of 3 cases and a review of the literature

  • Authors:
    • Hee Young Na
    • Young A Kim
    • Cheol Lee
    • Ji‑Young Choe
    • Seon Ah Shin
    • Jung‑Weon Shim
    • Soo Kee Min
    • Hyun‑Jung Kim
    • Jae Ho Han
    • Ji Eun Kim
  • View Affiliations

  • Published online on: May 18, 2018     https://doi.org/10.3892/ol.2018.8744
  • Pages: 741-748
  • Copyright: © Na et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Follicular lymphoma (FL) occurs primarily in the gastrointestinal tract, with the stomach being one of the rarest sites. According to the literature, <20 cases of primary gastric FL have been reported, with the number of cases with detailed pathological descriptions being even less. The aim of the present study was to compare clinicopathological features of gastric FL with FL at alternative sites. A total of 3 cases of gastric FL were retrieved from among 3,216 cases in the databases of 4 university hospitals in South Korea: Seoul National University (SNU) Hospital, SNU Boramae Hospital, SNU Bundang Hospital (all Seoul, South Korea) and Dongtan Sacred Heart Hospital Hallym University (Dongtan, South Korea), including 2 primary cases and 1 case that was possibly secondary to nodal FL. The 2 primary gastric FL cases were incidentally detected in routine health check‑ups. An endoscopy revealed a single polypoid submucosal mass and biopsies failed to confirm the diagnosis due to minimal mucosal involvement. Therefore, a partial gastrectomy was performed. The epicenters of the tumors were submucosal, with focal extension to the muscularis propria. However, 1 case exhibited an isolated FL nodule in the omentum. Histopathological examination revealed FL of grade 1‑2 with a follicular pattern and with strong expression of germinal center markers and B‑cell lymphoma 2 (BCL2). Rearrangement of BCL2 was not identified using fluorescence in situ hybridization studies in 2 cases. In contrast to these 2 cases, the remaining FL case was confirmed with an endoscopic biopsy. The endoscopy revealed multiple eroded polypoid lesions, and pathology revealed FL of grade 1‑2 with a predominantly diffuse pattern, and with immunoglobulin heavy chain IGH/BCL2 translocation. In view of the extensive lymphadenopathy, the last case possibly presented as secondary involvement of nodal FL. It is challenging to diagnose FL in the stomach due to little mucosal involvement, as well as the unfamiliarity of the tumor due to its rarity. However, the results of the present study suggest that primary gastric FL may exhibit unique pathological features, including a predominantly follicular pattern and an absence of BCL2 rearrangement.
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July-2018
Volume 16 Issue 1

Print ISSN: 1792-1074
Online ISSN:1792-1082

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Spandidos Publications style
Na HY, Kim YA, Lee C, Choe JY, Shin SA, Shim JW, Min SK, Kim HJ, Han JH, Kim JE, Kim JE, et al: Gastric follicular lymphoma: A report of 3 cases and a review of the literature. Oncol Lett 16: 741-748, 2018
APA
Na, H.Y., Kim, Y.A., Lee, C., Choe, J., Shin, S.A., Shim, J. ... Kim, J.E. (2018). Gastric follicular lymphoma: A report of 3 cases and a review of the literature. Oncology Letters, 16, 741-748. https://doi.org/10.3892/ol.2018.8744
MLA
Na, H. Y., Kim, Y. A., Lee, C., Choe, J., Shin, S. A., Shim, J., Min, S. K., Kim, H., Han, J. H., Kim, J. E."Gastric follicular lymphoma: A report of 3 cases and a review of the literature". Oncology Letters 16.1 (2018): 741-748.
Chicago
Na, H. Y., Kim, Y. A., Lee, C., Choe, J., Shin, S. A., Shim, J., Min, S. K., Kim, H., Han, J. H., Kim, J. E."Gastric follicular lymphoma: A report of 3 cases and a review of the literature". Oncology Letters 16, no. 1 (2018): 741-748. https://doi.org/10.3892/ol.2018.8744