Acute Pancreatitis Revealing a Diagnosis of Diffuse Large B-Cell Lymphoma

Abstract

Acute pancreatitis is a common gastroenterological condition that can occur due to several causes. While not required for diagnosis, imaging is often performed and may reveal unexpected findings such as pancreatic masses. Malignancies such as lymphoma are uncommon causes of acute pancreatitis, especially as the initial presentation of malignancy. We present a case of a young patient with acute pancreatitis caused by diffuse large B-cell lymphoma with extranodal disease secondarily involving the pancreas. Our case highlights the importance of keeping a broad differential for acute pancreatitis and considering rare etiologies such as pancreatic lymphoma in patients without another obvious culprit.

Keywords: acute pancreatitis; diffuse large B-cell lymphoma; pancreatic lymphoma.

Figure 1.

Magnetic resonance images reveal a 3.5 × 3.4 cm solid mass in the pancreatic tail (A) and a 3.9 × 3.1 cm solid mass in the pancreatic head (B).

Figure 2.

Histopathologic analysis of the pancreatic masses was consistent with diffuse large B-cell lymphoma with immunohistochemical (hematoxylin and eosin [H&E]) staining positive for CD45 and CD20. 40× magnification.

Figure 3.

Computed tompgraphy chest with contrast reveals a large anterior mediastinal mass that encases the origin of the great vessels and compresses the trachea (>50% narrowing just above the carina).