Underwater endoscopic mucosal resection of a follicular lymphoma: A case report

INTRODUCTION: Endoscopic resection of a follicular lymphoma (FL) presenting as a gastric subepithelial tumor (SET), along with periodic follow up can be a treatment option because gastrointestinal FL cells tend to reside in the primary site, which may explain its indolent nature. PATIENT CONCERNS: A gastric lesion was found incidentally during a screening endoscopy in 73-year-old woman without any gastrointestinal symptom. DIAGNOSIS: The patient was diagnosed with a grade I FL that was 1.4 cm large, at the greater curvature of lower-body. INTERVENTION: We performed underwater endoscopic mucosal resection (UW-EMR), and there was no serious complication, such as bleeding and perforation. OUTCOMES: Complete en bloc resection was achieved with UW-EMR. Follow-up endoscopic biopsy after 3 months revealed no residual tumor on the resection site. CONCLUSION: UW-EMR may be a simple and safe resection method for gastric FL without metastases, that measure >1 cm.