Primary pancreatic lymphoma in Korea--a single center experience

Abstract

The aim of this study was to report a single center experience of primary pancreatic lymphoma (PPL) in Korea. We analyzed the clinicopathological data from four PPL patients (three male, median age 36 yr) diagnosed from 1997 to 2007 at Seoul National University Hospital. The diagnoses were: diffuse large B cell lymphoma (n=2), Ki-1 (+) anaplastic large cell lymphoma (n=1), and Burkitt lymphoma (n=1). Presenting symptoms and signs were: abdominal pain (n=4), pancreatitis (n=2), weight loss (n=2) and abdominal mass (n=1). No patient underwent surgery. The Ann Arbor stages of the patients were: IEA (n=1), IIEA (n=1), and IVEB (n=2). Two patients underwent treatment. The stage IEA patient underwent chemotherapy and radiation therapy that resulted in a complete remission. The stage IVEB patient who underwent chemotherapy relapsed. This patient underwent subsequent peripheral blood stem cell transplantation and is alive at 30 months. Two patients (stages IVEB and IIEA) without treatment died at 0.8 and 7.0 months, respectively. For PPL patients, chemotherapy-based treatment, and addition of radiation therapy, if possible, may offer good prognosis.

Keywords: Lymphoma; Pancreas.

Fig. 1

Pathology findings of case 4. (A) Photomicrograph shows starry sky appearance and small non-cleaved cells (H&E, ×400). (B) The specimen shows immunoreactivity for Ki-67 and (C) bcl-6.

Fig. 2

CT findings of case 4. Homogenous, hypodense tumorous lesion is replacing almost the entire pancreas. (A) Dilatation of the main pancreatic duct is noted. Multiple nodules are also found in both kidneys. (B) CT taken 1 yr after peripheral blood stem cell transplantation shows disappearance of lesions in the pancreas and kidneys.