Photoclinic Diagnosis: Follicular Lymphoma of the Small Intestine

A38-year-old woman was referred to our gastrointestinal (GI) clinic. Her chief complaint was an epigastric pain since six months prior to referral. The pain was not positional and did not aggravate with activity. It was colicky in pattern lasting for 15 – 45 minutes and occurring at four-hour intervals, which was exacerbated after meal. She had 18 kg weight loss, vomiting and nausea, fever, chills, and anorexia since six months ago. She noted that her symptoms are reduced and she also gained weight (about 7 kg) in the past two months. Her medical history was negative for diabetes mellitus, hypertension, and hyperlipidemia. Physical examination revealed a mild tenderness of the abdomen and clubbing of her fingers. Laboratory data were in normal range. Abdominal ultrasonography was reported normal. Upper GI endoscopy and colonoscopy were normal too. An image from spiral computed tomography (CT).