PMC5348451_01
Esophagogastroduodenoscopy (EGD) and colonoscopy demonstrated numerous diffuse mucosal nodular lesions in the second portion of the duodenum (A) and colon (B). On follow-up EGD and colonoscopy, the size and number and of mucosal nodular lesions in the duodenum (C) and colon (D) had remarkably decreased compared with the lesions observed 2 years previously.
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Colonoscopy revealed diffuse mucosal nodularity throughout the whole colon and terminal ileum (Fig. 1A, B). Diffuse nodular lesions still existed from the duodenum to the colon, but they had remarkably decreased in size compared with the lesions that had been observed two years previously (Fig. 1C, D).
A small bowel series showed numerous small nodular lesions throughout the entire small bowel loop from the duodenum to the terminal ileum.
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There were numerous small nodular lesions in the entire small bowel from the duodenum to the terminal ileum in a small bowel series (Fig. 2).
(A) A low power view of the duodenal mucosal tissue showed relatively well-preserved villous epithelial architecture and well-formed lymphoid follicles in the lamina propria [Hematoxylin and Eosin (H&E) staining, x40]. (B) A high power view showed expansile hyperplastic germinal centers demonstrating well-preserved polarity from the dark to light zone, characteristics of reactive germinal centers, and sharply delineated by a thin layer of mantle zone (H&E staining, x200). Immunohistochemical staining showed the characteristic features of reactive lymphoid hyperplasia with CD20 (C), CD3 (D), and Bcl-2 (E). (F) No lymphoepithelial lesions were noted on immunohistochemical staining for Cytokeratin (x100).
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There was no evidence of lymphoepithelial lesions (Fig. 3A, B), and no organisms were detected. The results of immunohistochemical staining were compatible with reactive lymphoid hyperplasia (Fig. 3C-F).