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. 2014 May;46(5):470-3.
doi: 10.1016/j.dld.2013.12.016. Epub 2014 Feb 18.

Frequency of occurrence and characteristics of primary pancreatic lymphoma during endoscopic ultrasound guided fine needle aspiration: a retrospective study

Jayapal Ramesh  1 , Shantel Hebert-Magee  2 , Hwasoon Kim  3 , Jessica Trevino  3 , Shyam Varadarajulu  4
Affiliations

Frequency of occurrence and characteristics of primary pancreatic lymphoma during endoscopic ultrasound guided fine needle aspiration: a retrospective study

Jayapal Ramesh et al. Dig Liver Dis. 2014 May.

Abstract

Background: Primary pancreatic lymphoma is a rare tumour of the pancreas. Data on the role of endoscopic ultrasound guided fine needle aspiration for its diagnosis are scant.

Aim: To identify the frequency of occurrence, sonographic characteristics and cytological findings that are predictive of primary pancreatic lymphoma.

Methods: Pancreatic lymphoma cases were identified by retrospective review of solid pancreatic masses over 10-year period.

Results: 12/2397 (0.5%) lesions were identified. Patients were predominantly white (92%) and male (58%). Mean largest dimension was 47.5mm and 83.3% were located in the head. The mass appeared heterogeneous in 75% and peripancreatic lymphadenopathy was noted in 58%. None of the patients showed features of chronic pancreatitis or pancreatic ductal dilation. Rapid onsite analysis revealed atypical lymphocytes in 92%. Flow cytometry confirmed diagnosis in 75% of cases.

Conclusions: Primary pancreatic lymphoma is encountered in 0.5% of patients undergoing endoscopic ultrasound guided fine needle aspiration. A large heterogeneous mass, in the absence of chronic pancreatitis or pancreatic duct dilation that reveals atypical lymphocytes on fine needle aspiration is suggestive.

Keywords: EUS; EUS-FNA; Flow cytometry; Primary pancreatic lymphoma.

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Conflict of interest statement

Conflict of interest statement

Jayapal Ramesh, Shantel Hebert-Magee, Hwasoon Kim, Jessica Trevino had no conflict of interest. Shyam Varadarajulu is a Consultant for Olympus America and Boston Scientific Corporation.

Figures

Fig. 1
Fig. 1
Low power (×10) rapid onsite evaluation reveals predominant distribution of atypical lymphocytes throughout field.
Fig. 2
Fig. 2
High power view (×40) shows numerous large monotonous lymphocytes with open chromatin admixed with small, dark, round, mature lymphocytes.
Fig. 3
Fig. 3
Linear echoendoscopic view of heterogeneous pancreatic head mass.
See this image and copyright information in PMC

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