Primary Pancreatic Lymphoma: An Uncommon Presentation in the Pancreatic Tail

Abstract

Primary pancreatic lymphoma is a rare form of pancreatic cancer that represents a diagnostic and therapeutic challenge due to its rarity and presentation mimicking pancreatic adenocarcinoma. Herein, we report a case of a 57-year-old Caucasian male who presented with left-sided chest pain, epigastric pain, and melena. Abdominal imaging was remarkable for a large, necrotic mass near the tail of the pancreas extending into the splenic hilum and left kidney. Biopsy of the mass confirmed lymphoma of B-cell origin. The patient was diagnosed with Stage IV disease and started on chemotherapy. This case combines an uncommon presentation of lymphoma with a rarely documented primary site in the tail of the pancreas.

Keywords: diffuse large b-cell lymphoma (dlbcl); lymphoma of b-cell origin; pancreatic cancer; pancreatic mass; primary pancreatic lymphoma.

Figure 1. Computed tomography scan of the abdomen showing an 8.3 x 5.3 cm mass centered around the splenic hilum and tail of the pancreas.

Figure 2. Hematoxylin and Eosin staining at 40x magnification of the core biopsy specimen obtained from the pancreatic mass, showing large cells with vesicular chromatin and small nucleoli. Pathology is consistent with a diffuse large B-cell lymphoma.