Recent updates on treatment options for primary follicular lymphoma of the gastrointestinal tract

ABSTRACT

Background

Primary gastrointestinal follicular lymphoma is a subtype of follicular lymphoma that originates directly from the gastrointestinal tract. Pathologically, it exhibits substantial similarities with the secondary gastrointestinal involvement observed in nodal follicular lymphoma. However, primary gastrointestinal follicular lymphoma presents clinically distinct features, necessitating divergent considerations in treatment selection compared with nodal follicular lymphoma.

Areas covered

This narrative review focused on recent articles (2018–2023) regarding the long-term prognosis and treatment options for gastrointestinal follicular lymphoma. In addition, a brief overview of gastrointestinal follicular lymphomas is provided.

Expert opinion

Patients with primary gastrointestinal follicular lymphoma often present with a low tumor burden. Lymphoma lesions typically remain asymptomatic for several years or may undergo spontaneous regression without immediate treatment. Therefore, a ‘watch and wait’ approach is justified. Conversely, when large tumor masses are identified in the gastrointestinal tract, the potential for tumor bleeding or intestinal obstruction requires timely therapeutic interventions.

KEYWORDS:

• Colonoscopy
• esophagogastroduodenoscopy
• follicular lymphoma
• gastrointestinal lymphoma
• watch and wait

Article highlights

• Primary gastrointestinal follicular lymphoma represents a subtype that originates from the gastrointestinal tract.

• Gastrointestinal follicular lymphoma is generally asymptomatic and detected incidentally during endoscopic examinations of the duodenum as whitish, polypoid, or granular lesions.

• The clinical behavior of primary gastrointestinal follicular lymphoma is generally favorable.

• A watch and wait approach is justified for patients with gastrointestinal follicular lymphoma with a low tumor burden.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.