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Case Reports
. 2012 May;6(2):438-45.
doi: 10.1159/000339968. Epub 2012 Jul 5.

Clues for diagnosing primary pancreatic lymphoma

Zhongzhen Li  1 , Shaoxiong Zhang, Nadiya Vasdani, Eddy Castillo
Affiliations
Case Reports

Clues for diagnosing primary pancreatic lymphoma

Zhongzhen Li et al. Case Rep Gastroenterol. 2012 May.

Abstract

Primary pancreatic lymphoma (PPL), a localized lymphoma in the pancreas, accounts for <0.5% of all pancreatic masses and presents with symptoms favoring the more common adenocarcinoma. It is important to differentiate PPL from adenocarcinoma since treatment and prognosis differ considerably. PPL is potentially curable with chemotherapy, especially if it is diagnosed at early stages. A definitive diagnosis can only be based on histopathological findings. Endoscopic ultrasound-guided fine needle aspiration (EUS-guided FNA) is a reliable, minimally invasive and cost-effective method for this purpose. Even though there are neither typical clinical features nor specific biomarker for the diagnosis of PPL, certain common presentations have been observed which may indicate PPL. We herein present the case of a 43-year-old man who was successfully diagnosed with PPL by EUS-guided FNA. His clinical, laboratory and radiographic findings supported PPL over adenocarcinoma as well. This case demonstrates that high clinical suspicion based on clinical, laboratory and imaging features is critical in PPL diagnosis and management.

Keywords: Endoscopic ultrasound; Primary pancreatic lymphoma.

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Figures

Fig. 1
Fig. 1
CT scan of the abdomen with contrast: heterogeneous mass measuring 12.0 × 9.7 × 14.3 cm in the right upper quadrant with loss of fat planes between the stomach, duodenum, colon and pancreas.
Fig. 2
Fig. 2
EUS: heterogeneous mass in the head of the pancreas with surrounding free fluid and multiple collateral vessels.
Fig. 3
Fig. 3
EUS-guided FNA biopsy of the pancreatic head mass: atypical lymphoid cells with condensed chromatin and larger lymphomatous cells (40×).
Fig. 4
Fig. 4
Immunohistochemistry studies. a CD20 positive (40×). b CD10 positive (40×). c BCL-2 positive (40×). d BCL-6 positive (duodenum, 4×). e PAX5 positive (duodenum, 4×).
Fig. 5
Fig. 5
Cytometry: CD10 positive B cell lymphoma.
See this image and copyright information in PMC

References

    1. Zucca E, Roggero E, Bertoni F, Cavalli F. Primary extranodal non-Hodgkin's lymphomas. Part 1: Gastrointestinal, cutaneous and genitourinary lymphomas. Ann Oncol. 1997;8:727–737. - PubMed
    1. Alexander RE, Nakeeb A, Sandrasegaran K, Robertson MJ, An C, Al-Haddad MA, Chen JH. Primary pancreatic follicle center-derived lymphoma masquerading as carcinoma. Gastroenterol Hepatol (N Y) 2011;7:834–838. - PMC - PubMed
    1. Battula N, Srinivasan P, Prachalias A, Rela M, Heaton N. Primary pancreatic lymphoma: diagnostic and therapeutic dilemma. Pancreas. 2006;33:192–194. - PubMed
    1. Du X, Zhao Y, Zhang T, Liao Q, Dai M, Liu Z, Guo J, Hu Y. Primary pancreatic lymphoma: a clinical quandary of diagnosis and treatment. Pancreas. 2011;40:30–36. - PubMed
    1. Forsmark CE, Lambiase L, Vogel SB. Diagnosis of pancreatic cancer and prediction of unresectability using the tumor-associated antigen CA19-9. Pancreas. 1994;9:731–734. - PubMed

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