54 year female with 4-5 years of non-specific GI complaints. Presented to the hospital with small bowel obstruction. Had surgical resection of segment of small bowel revealing Follicular Lymphoma grade 1-2. Several additional nodes were removed, pathology was the same. Patient has now recovered from surgery and feels well. No symptoms. Post-operative PET scan revealed multiple small retroperitoneal and mesenteric lymph nodes, highest SUV was 2.2. My recommendation to her is only active surveillance at this time since she feels well, would you recommend any additional therapy at this time?
Duodenal type FL is a very indolent type of FL which usually does not require any treatment after initial diagnosis. Based on what you describe it appears that your patient fits this criteria and therefore active surveillance is the most optimal strategy. I would not repeat scans unless symptomatic in the future. Prognosis is excellent.
