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- W2978553430 abstract "A 34 year-old male with a prior history of GERD on a PPI was referred to the gastroenterology clinic for further evaluation of GERD and dysphagia. The dysphagia had been present for 3 years and was associated with starches and meats and relieved by water ingestion. The patient also reported worsening control of regurgitation symptoms associated with his GERD. On further review of systems, patient denied fevers, chills, nausea, vomiting, diarrhea, constipation, pyrosis, odynophagia, hematochezia, melena, abdominal pain, weight loss, change in bowel habits or change in stool caliber. The patient denied tobacco or alcohol use. There was no family history of colorectal cancer, gastric cancer, or other gastrointestinal malignancies or disease. A barium swallow showed a small hiatal hernia with no significant gastroesophageal reflux as well as mild gastric fold thickening suggesting gastritis with no evidence of dysmotility. An EGD was performed which showed frond-like mucosa in the second part of the duodenum covering two-thirds of the duodenal wall opposite to the ampulla. A biopsy of the mucosa demonstrated findings consistent with follicular lymphoma. Further oncological work up revealed a normal bone marrow biopsy with normal flow cytometry, normal cytogenetic analysis, and a normal karyotype. A PET/CT scan demonstrated prominent mesenteric lymph nodes with no hypermetabolic activity and no evidence of metastasis. With no other source of lymphoma seen on further work-up, the tumor was diagnosed as a primary duodenal follicular lymphoma. Treatment consists of either monitoring, rituximab monotherapy, rituximab plus an anthracycline-based chemotherapy regimen such as CHOP, radiation, surgery, or combinations of the above. Prognosis is very good with most studies showing no deaths attributed to the lymphoma even in those with more advanced disease. As these lesions tend to have an indolent course, the plan was to monitor with serial pill endoscopy and only treat if patient developed symptoms necessitating intervention. This case was interesting in that this was a rare endoscopic finding with a very atypical clinical presentation.Figure 1Figure 2Figure 3" @default.
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- W2978553430 date "2016-10-01" @default.
- W2978553430 modified "2023-09-27" @default.
- W2978553430 title "Rare Malignancy Found on Endoscopy for GERD Associated with Dysphagia" @default.
- W2978553430 doi "https://doi.org/10.14309/00000434-201610001-02104" @default.
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