| セッション情報 |
International Session7(消化器内視鏡学会・消化器病学会合同)
Small bowel endoscopy-Where are we,and where to go?
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| タイトル |
消IS7-11：Diagnosis and Therapeutic Assessment of Early-Stage Follicular Lymphoma with Small-bowel Involvement Using Videocapsule Endoscopy and Double-Balloon Endoscopy
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| 演者 |
M. Nakamura（Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine） |
| 共同演者 |
N. Ohmiya（Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine）, H. Goto（Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine） |
| 抄録 |
Background and Study Aims: We aimed to determine the role of videocapsule endoscopy (VCE) and double-balloon endoscopy (DBE) for the management of early-stage follicular lymphoma (FL) with small-bowel involvement.Patients and methods: Twenty-seven patients have undergone DBE and VCE. We analyzed pathologic diagnostic yields of biopsy specimens at DBE, endoscopic findings, and location of the lesions. Pathologic findings of biopsies at DBE were analyzed during the follow-up period after rituximab-monotherapy for FL at stage I.Results: Pathologic diagnostic yields of polypoid lesions (75%) and wall changes (88%) were significantly higher than that of Peyer's patch (35%) (P=0.0006, 0.0002, respectively). Pathologic diagnostic yields stratified by localization were 91% in the proximal duodenum at esophagogastroduodenoscopy, 88% in the jejunum at antegrade DBE, 51% in the ileum at retrograde DBE, and 53 % in the terminal ileum at colonoscopy with ileal intubation. VCE and DBE were indeed useful in 44% of patients. Of 13 patients who underwent total enteroscopy with biopsy before and after rituximab monotherapy, complete remission was confirmed in 6 patients. Enteroscopic finding of residual lesions in the ileum could not be distinguished from the normal lymphoid follicle after treatment.Conclusion: VCE may be recommended for determining the existence of the small-bowel lesions before treatment. When antitumor response is assessed after treatment, DBE with pathologic diagnosis is necessary. |
| 索引用語 |
follicular lymphoma, small bowel |
