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Volume 83 - 2020 - Fasc.3 - Letters

Is bendamustine plus rituximab a suitable option for rituximab-refractory duodenal-type follicular lymphoma?

Duodenal follicular lymphoma (DFL) is a specific variant of FL, predominantly localized in the second portion of the duodenum and often represents an incidental finding, even if some cases can present with abdominal pain. Overall prognosis is excellent, with high progression-free survival (PFS) and overall survival (OS) (1). Watch&wait, rituximab or radiotherapy (RT) should represent a suitable first-line therapy with long-term efficacy (1-4). However, a small proportion of rituximab- refractory patients exists. Here we would like to report a rituximab-refractory DFL successfully treated with rituximab and bendamustine (BR).


Air in the whole body after colonoscopy in a patient with ulcerative colitis

In previous reports, the authors described patients suffering bilateral tension pneumothorax during colonoscopy and laparoscopic procedure (1,2). Here we report a case with ulcerative colitis also found catastrophic complications with bilateral tension pneumothorax after colonoscopy. A 44-year-old man, American Society Anesthesio- logists class II, was scheduled for diagnostic colonoscopy under monitored anesthesia care. He had a past history of ulcerative colitis and hepatitis C with regular control. Preoperative examinations were unremarkable. At his visit, vital signs were follows: noninvasive blood pressure (NIBP) of 158/80 mmHg, heart rate (HR) of 110 beats per min (bpm) and room air oxygen saturation (SpO2) of 100%. In the exam room, we gave the patient 2% xylocaine 50 mg intravenous and continuous infusion of propofol under controlled infusion (Orchestra® Base Primea, Fresenius Vial, Brezins, France) with Schnider model Ce: 4.0-7.0 mcg/ml. The colonoscopic examination revealed diffuse ulcers over descending and sigmoid colon and rectum compatible with ulcerative colitis, and a 4 cm polypoid mass impacted over the rectum and sigmoid colon about 10 cm level. However, the operator suspected air leakage from the equipment because inadequate air inflation persisted during procedure. The procedure took 40 minutes.