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Journal of Gastroenterology

, Volume 45, Issue 4, pp 370–388 | Cite as

Gastrointestinal follicular lymphoma: review of the literature

  • Shuji Yamamoto
  • Hiroshi Nakase
  • Kouhei Yamashita
  • Minoru Matsuura
  • Mariko Takada
  • Chiharu Kawanami
  • Tsutomu Chiba
Review

Abstract

Gastrointestinal follicular lymphoma (GI-FL) is a relatively rare disease, accounting for only 1%-3.6% of gastrointestinal non-Hodgkin’s lymphoma. Although the duodenum and terminal ileum are considered to be the most common sites of origin, the development of wireless capsule endoscopy and double-balloon enteroscopy has increased the detection of GI-FL in every part of the small intestine. Approximately 70% of patients with GI-FL are estimated to have multiple lesions throughout the entire gastrointestinal tract. FL is a low-grade lymphoma that usually develops very slowly. If the lymphoma causes no symptoms, immediate treatment may not be necessary. Standard therapy has not yet been established for GI-FL, but chemotherapy, radiotherapy, monoclonal antibody therapy, or a combination of these therapies, is sometimes performed based on the therapeutic regimens for nodal FL. Regimens including conventional chemotherapy with rituximab, which achieve high response rates in nodal FL, are commonly used for GI-FL. The long-term clinical outcome of GI-FL is unclear. The results of a few series on the long-term outcomes of patients with GI-FL treated with conventional therapy indicate a median relapse-free time ranging from 31 to 45 months. On the other hand, in patients with GI-FL who were followed without treatment, the median time to disease progression was 37.5 months. Thus, whether to initiate aggressive therapy or whether to continue watchful waiting in patients with GI-FL is a critically important decision. Ongoing research on biomarkers to guide individualized GI-FL therapy may provide invaluable information that will lead to the establishment of a standard therapeutic regimen.

Keywords

Follicular lymphoma Gastrointestinal tract Multiple lymphomatous polyposis 

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Copyright information

© Springer 2010

Authors and Affiliations

  • Shuji Yamamoto
    • 1
    • 2
  • Hiroshi Nakase
    • 1
  • Kouhei Yamashita
    • 3
  • Minoru Matsuura
    • 1
  • Mariko Takada
    • 4
  • Chiharu Kawanami
    • 4
  • Tsutomu Chiba
    • 1
  1. 1.Department of Gastroenterology and Hepatology, Graduate School of MedicineKyoto UniversityKyotoJapan
  2. 2.Japan Society for the Promotion of ScienceTokyoJapan
  3. 3.Department of Hematology and Oncology, Graduate School of MedicineKyoto UniversityKyotoJapan
  4. 4.Department of GastroenterologyKobe City Medical Center General HospitalKobeJapan

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