Clinical Journal of Gastroenterology

, Volume 10, Issue 2, pp 147–153 | Cite as

Follicular lymphoma-related colitis resembling ulcerative colitis

  • Takahiro ZendaEmail author
  • Noriharu Nakagawa
  • Hiroyuki Maruyama
  • Tamao Endo
  • Kotaro Higashi
  • Junpei Yamamoto
  • Keigo Komai
  • Kishichiro Watanabe
  • Ichiro Araki
Case Report


Among the various manifestations of colonic involvement in malignant lymphomas, an ulcerative colitis-like appearance is rare. Herein, we describe a case in which extranodal colonic involvement resembled ulcerative colitis in a patient with advanced follicular lymphoma. A 59-year-old Japanese man with diarrhea and body weight loss was referred to our hospital. Computed tomography (CT) revealed systemic lymphadenopathy, splenomegaly, and thickening of the sigmoid colon and rectum walls. 18F-fluorodeoxy-glucose positron emission tomography (18F-FDG-PET/CT) revealed intense tubular 18F-FDG accumulation extending from the rectum to the colon at the hepatic flexure and much weaker accumulation in the systemic lymph nodes, bone marrow, and spleen. The isotope-enriched areas had an ulcerative colitis-like appearance as shown via colonoscopy. The patient was ultimately diagnosed with follicular lymphoma (stage IV A, grade 1) based on a pathological examination of the neck lymph nodes, iliac bone marrow, and colon. After six courses of chemotherapy (R-CHOP), 18F-FDG-PET/CT confirmed complete remission of the lymphoma including the colonic lesion. This is presumably the first case of ulcerative-like colitis caused by a follicular lymphoma. As a novel approach, the lymphoma-related colitis was detected by comparing the pathology results and the 18F-FDG-PET/CT results.


Follicular lymphoma Lymphoma-related colitis Ulcerative colitis 18F-FDG-PET/CT Lymphomatous colitis 


Compliance with ethical standards

Conflict of Interest:

None of the authors have received any grant associated with this case report. All authors (Takahiro Zenda, Noriharu Nakagawa, Hiroyuki Maruyama, Tamao Endo, Kotaro Higashi, Junpei Yamamoto, Keigo Komai, Kishichiro Watanabe, Ichiro Araki) declare that they have no conflict of interest.

Human Rights:

All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed Consent:

Informed consent was obtained from the patient for being reported in this journal.


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Copyright information

© Japanese Society of Gastroenterology 2016

Authors and Affiliations

  • Takahiro Zenda
    • 1
    Email author
  • Noriharu Nakagawa
    • 1
    • 5
  • Hiroyuki Maruyama
    • 6
  • Tamao Endo
    • 2
  • Kotaro Higashi
    • 2
  • Junpei Yamamoto
    • 3
  • Keigo Komai
    • 4
  • Kishichiro Watanabe
    • 4
    • 7
  • Ichiro Araki
    • 1
  1. 1.Department of Internal MedicineAsanogawa General HospitalKanazawaJapan
  2. 2.Department of RadiologyAsanogawa General HospitalKanazawaJapan
  3. 3.Department of OtolaryngologyAsanogawa General HospitalKanazawaJapan
  4. 4.Department of PathologyAsanogawa General HospitalKanazawaJapan
  5. 5.Department of HematologyGraduate School of Medical Science, Kanazawa UniversityKanazawaJapan
  6. 6.Department of Internal MedicineKeijyu Kanazawa HospitalKanazawaJapan
  7. 7.Watanabe’s Consultancy for Pathological DiagnosisKanazawaJapan

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