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• W2912894985 abstract "Introduction: Extranodal non-Hodgkin's lymphomas (NHLs) represents to 35-40% of all NHL cases with gastrointestinal tract is the most commonly involved site. Primary pancreatic lymphoma (PPL) is an extremely uncommon but well-documented tumors of the pancreas. It can present as an isolated mass mimicking pancreatic carcinoma. The typical clinical presentation includes abdominal pain, jaundice, acute pancreatitis, diarrhea, weight loss or small bowel obstruction. We present a case of diffuse PPL that was treated with chemotherapy alone. Case: The patient is a 67-year-old white female who experienced a 3-4 month history of non-specific abdominal pain with the feeling of indigestion. She was initially presumed to have colitis and was prescribed antibiotics by her primary care provider. However, her symptoms did not improve. Patient denies any history of back pain, nausea, vomiting, and jaundice or weight loss. Physical examination was negative for jaundice, lymphadenopathy, or an abdominal mass but positive for splenomegaly. Her blood work was unremarkable including normal CA19-9. She had CT abdomen that showed large infiltrative mass involving the body and tail of the pancreas, spleen, left adrenal gland, upper pole of the left kidney, and stomach measures 10.0 x 11.0 x 10.0 CM in size (Figure 1). She also noted to have complete occlusion of the splenic vein and enlarged mesenteric lymph nodes. Endoscopic ultrasound (EUS) revealed a cystic mass in the pancreas tail measuring 4.5 cm, with a normal CA 19-9. EUS guided FNA of the mass showed the presence of many medium to large sized atypical lymphoid cells (Figure 2) highly suspicious for B-Cell NHL. Immunostaining was positive for CD45, and PAX 5 with very high proliferative index (Ki-67) over 90% percent confirmed the diagnosis. The patient was started on chemotherapy with R-EPOCH (Rituximab+Etoposide + Prednisone + Vincristine + Cyclophosphamide + Doxorubicin). She had received six cycles of chemotherapy and achieved complete remission.Figure: Pancreatic mass involving the body and tail of the pancreas, spleen, left adrenal gland, upper pole of the left kidney, and stomach measuring 10.0 x 11.0 x 10.0 CM in size.Figure: FNA of the mass showed the presence of many medium to large sized atypical lymphoid cells highly suspicious for non-Hodgkin's lymphoma.Conclusion: Biopsy of all pancreatic masses is crucial to differentiate potentially treatable conditions such as PPL. Treatment usually consists of a combination of chemotherapy and radiation therapy. PPL have a much favorable prognosis than adenocarcinoma of the pancreas." @default.
• W2912894985 created "2019-02-21" @default.
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• W2912894985 date "2017-10-01" @default.
• W2912894985 modified "2023-10-17" @default.
• W2912894985 title "Primary Pancreatic Lymphoma: A Rare Cause of Pancreatic Malignancy" @default.
• W2912894985 doi "https://doi.org/10.14309/00000434-201710001-01269" @default.
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