PMC5533599_01
Oesophagogastroduodenoscopy images of the duodenum. Initially, white villi are sparsely observed in the second portion of the duodenum (A). Eight months later, the duodenal lymphangiectasia is unchanged (B). Endoscopy examinations performed six months (C) and twelve months (D) after radiotherapy show gradual progression of the lymphangiectasia.
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Oesophagogastroduodenoscopy performed eight months before admission revealed sparse white villi in the second portion of the duodenum (Figure 1A). Oesophagogastroduodenoscopy performed before radiotherapy revealed that the gastric MALT lymphoma and duodenal lymphangiectasia (Figure 1B) were unchanged since eight months. On the contrary, whitish villi in the duodenum increased in number with time (Figure 1C, D).
Oesophagogastroduodenoscopy images of the gastric MALT lymphoma. A pale lesion with indistinct boundaries is noted under white light observation (A) and magnifying observation with narrow-band imaging (B). Endoscopic ultrasonography confirms that the lymphoma is confined to the gastric mucosal layer (C).
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In addition, a pale lesion with indistinct boundaries was noted in the greater curvature of the gastric body (Figure 2A, B). Endoscopic ultrasonography confirmed that the MALT lymphoma was confined to the gastric mucosal layer (Figure 2C).
Oesophagogastroduodenoscopy images taken 55 months after radiotherapy show obviously worsened duodenal lymphangiectasia (A). Magnifying observation shows dilated, whitish duodenal villi (B). The margins of the villi are distinct. Magnifying observation with narrow-band imaging reveals elongated microvasculature within the villi (C).
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Fifty-five months after radiotherapy, the duodenal lymphangiectasia obviously worsened (Figure 3).
Pathological images of the duodenal lymphangiectasia. Biopsy examination reveals dilated lymphatic duct in the duodenal villi.
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Biopsy revealed dilated lymphatic duct in the duodenal villi (Figure 4).