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Abdominal Radiology
Published in: Abdominal Radiology 2/2015

01-02-2015 | Pictorial Essay

Hematologic malignancies of the pancreas

Authors: Kumar Sandrasegaran, Anderanik Tomasian, Khaled M. Elsayes, Harris Nageswaran, Akram Shaaban, Alampady Shanbhogue, Christine O. Menias

Published in: Abdominal Radiology | Issue 2/2015

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Abstract

Hematologic malignancies are relatively uncommon neoplasms of abdominal soft tissue. This article discusses the clinical and imaging features of pancreatic lymphoma, pancreatic extraosseous multiple myeloma, granulocytic sarcoma (chloroma), posttransplant lymphoproliferative disorder, and Castleman disease. The combination of imaging findings and the appropriate clinical presentation should allow the radiologist to raise a provisional diagnosis of hematologic malignancy.
Literature
1.
Nayer H, Weir EG, Sheth S, Ali SZ (2004) Primary pancreatic lymphomas: a cytopathologic analysis of a rare malignancy. Cancer 102:315–321PubMedCrossRef
2.
3.
Dawson IM, Cornes JS, Morson BC (1961) Primary malignant lymphoid tumours of the intestinal tract. Report of 37 cases with a study of factors influencing prognosis. Br J Surg 49:80–89PubMedCrossRef
4.
Behrns KE, Sarr MG, Strickler JG (1994) Pancreatic lymphoma: is it a surgical disease? Pancreas 9:662–667PubMedCrossRef
5.
Nishimura R, Takakuwa T, Hoshida Y, Tsujimoto M, Aozasa K (2001) Primary pancreatic lymphoma: clinicopathological analysis of 19 cases from Japan and review of the literature. Oncology 60:322–329PubMedCrossRef
6.
Battula N, Srinivasan P, Prachalias A, Rela M, Heaton N (2006) Primary pancreatic lymphoma: diagnostic and therapeutic dilemma. Pancreas 33:192–194PubMedCrossRef
7.
8.
Fujinaga Y, Lall C, Patel A, et al. (2013) MR features of primary and secondary malignant lymphoma of the pancreas: a pictorial review. Insights Imaging 4:321–329PubMedCentralPubMedCrossRef
9.
Ji Y, Kuang TT, Tan YS, et al. (2005) Pancreatic primary lymphoma: a case report and review of the literature. Hepatobiliary Pancreat Dis Int 4:622–626PubMed
10.
Lin H, Li SD, Hu XG, Li ZS (2006) Primary pancreatic lymphoma: report of six cases. World J Gastroenterol 12:5064–5067PubMedCentralPubMed
11.
Merkle EM, Bender GN, Brambs HJ (2000) Imaging findings in pancreatic lymphoma: differential aspects. AJR Am J Roentgenol 174:671–675PubMedCrossRef
12.
Prayer L, Schurawitzki H, Mallek R, Mostbeck G (1992) CT in pancreatic involvement of non-Hodgkin lymphoma. Acta Radiol 33:123–127PubMedCrossRef
13.
14.
15.
Bhosale PR, Menias CO, Balachandran A, et al. (2013) Vascular pancreatic lesions: spectrum of imaging findings of malignant masses and mimics with pathologic correlation. Abdom Imaging 38:802–817PubMedCrossRef
16.
Coakley FV, Hanley-Knutson K, Mongan J, et al. (2012) Pancreatic imaging mimics: part 1, imaging mimics of pancreatic adenocarcinoma. AJR Am J Roentgenol 199:301–308PubMedCrossRef
17.
Suzuki K, Itoh S, Nagasaka T, et al. (2010) CT findings in autoimmune pancreatitis: assessment using multiphase contrast-enhanced multisection CT. Clin Radiol 65:735–743PubMedCrossRef
18.
Ferrozzi F, Bova D, Campodonico F, et al. (1997) Pancreatic metastases: CT assessment. Eur Radiol 7:241–245PubMedCrossRef
19.
Shin JU, Lee JK, Kim KM, et al. (2013) The differentiation of autoimmune pancreatitis and pancreatic cancer using imaging findings. Hepatogastroenterology 60:1174–1181PubMed
20.
Chou YH, Chiou HJ, Hong TM, et al. (2002) Solitary metastasis from renal cell carcinoma presenting as diffuse pancreatic enlargement. J Clin Ultrasound 30:499–502PubMedCrossRef
21.
Yang J, Kan Y, Ge BH, et al. (2013) Diagnostic role of gallium-68 DOTATOC and gallium-68 DOTATATE PET in patients with neuroendocrine tumors: a meta-analysis. Acta Radiol . doi:10.​1177/​0284185113496679​
22.
Ishigami K, Tajima T, Nishie A, et al. (2010) MRI findings of pancreatic lymphoma and autoimmune pancreatitis: a comparative study. Eur J Radiol 74:e22–e28PubMedCrossRef
23.
Manfredi R, Frulloni L, Mantovani W, et al. (2011) Autoimmune pancreatitis: pancreatic and extrapancreatic MR imaging-MR cholangiopancreatography findings at diagnosis, after steroid therapy, and at recurrence. Radiology 260:428–436PubMedCrossRef
24.
Cheuk W, Chan JK (2012) Lymphadenopathy of IgG4-related disease: an underdiagnosed and overdiagnosed entity. Semin Diagn Pathol 29:226–234PubMedCrossRef
25.
Ganeshan D, Iyer R, Devine C, Bhosale P, Paulson E (2013) Imaging of primary and secondary renal lymphoma. AJR Am J Roentgenol 201:W712–W719PubMedCrossRef
26.
Khalili K, Doyle DJ, Chawla TP, Hanbidge AE (2008) Renal cortical lesions in patients with autoimmune pancreatitis: a clue to differentiation from pancreatic malignancy. Eur J Radiol 67:329–335PubMedCrossRef
27.
Sasiwimonphan K, Gorman B, Kawashima A, Chari ST, Takahashi N (2012) Renal involvement in patients with autoimmune pancreatitis: ultrasound findings. Eur J Radiol 81:807–810PubMedCrossRef
28.
Sheth S, Ali S, Fishman E (2006) Imaging of renal lymphoma: patterns of disease with pathologic correlation. Radiographics 26:1151–1168PubMedCrossRef
29.
Takahashi N, Kawashima A, Fletcher JG, Chari ST (2007) Renal involvement in patients with autoimmune pancreatitis: CT and MR imaging findings. Radiology 242:791–801PubMedCrossRef
30.
Triantopoulou C, Malachias G, Maniatis P, et al. (2010) Renal lesions associated with autoimmune pancreatitis: CT findings. Acta Radiol 51:702–707PubMedCrossRef
31.
Van Beers B, Lalonde L, Soyer P, et al. (1993) Dynamic CT in pancreatic lymphoma. J Comput Assist Tomogr 17:94–97PubMedCrossRef
32.
Dong A, Dong H, Zhang L, Zuo C (2013) Hypermetabolic lesions of the pancreas on FDG PET/CT. Clin Nucl Med 38:e354–e366PubMedCrossRef
33.
Kaneta T, Hakamatsuka T, Yamada T, et al. (2006) FDG PET in solitary metastastic/secondary tumor of the kidney: a report of three cases and a review of the relevant literature. Ann Nucl Med 20:79–82PubMedCrossRef
34.
Zhang J, Shao C, Wang J, et al. (2013) Autoimmune pancreatitis: whole-body 18F-FDG PET/CT findings. Abdom Imaging 38:543–549PubMedCrossRef
35.
Yoon SN, Lee MH, Yoon JK (2004) F-18 FDG positron emission tomography findings in primary pancreatic lymphoma. Clin Nucl Med 29:574–575PubMedCrossRef
36.
Du X, Zhao Y, Zhang T, et al. (2011) Primary pancreatic lymphoma: a clinical quandary of diagnosis and treatment. Pancreas 40:30–36PubMedCrossRef
37.
Koniaris LG, Lillemoe KD, Yeo CJ, et al. (2000) Is there a role for surgical resection in the treatment of early-stage pancreatic lymphoma? J Am Coll Surg 190:319–330PubMedCrossRef
38.
Freedman A (2012) Follicular lymphoma: 2012 update on diagnosis and management. Am J Hematol 87:988–995PubMedCrossRef
39.
Seiler TM, Hiddemann W (2012) Advances in the management of follicular lymphoma. Curr Opin Oncol 24:742–747PubMedCrossRef
40.
Ujjani C, Cheson BD (2013) The current status and future impact of targeted therapies in non-Hodgkin lymphoma. Expert Rev Hematol 6:191–202; quiz 203
41.
Mishra MV, Keith SW, Shen X, et al. (2013) Primary pancreatic lymphoma: a population-based analysis using the SEER program. Am J Clin Oncol 36:38–43PubMedCrossRef
42.
Izadi M, Fazel M, Saadat SH, Taheri S (2011) Hepatic involvement by lymphoproliferative disorders post liver transplantation: PTLD. International Surveys. Hepatol Int 5:759–766PubMedCrossRef
43.
Green M, Webber S (2003) Posttransplantation lymphoproliferative disorders. Pediatr Clin N Am 50:1471–1491CrossRef
44.
Jagadeesh D, Woda BA, Draper J, Evens AM (2012) Post transplant lymphoproliferative disorders: risk, classification, and therapeutic recommendations. Curr Treat Options Oncol 13:122–136PubMedCrossRef
45.
Glotz D, Chapman JR, Dharnidharka VR, et al. (2012) The Seville expert workshop for progress in posttransplant lymphoproliferative disorders. Transplantation 94:784–793PubMedCrossRef
46.
Bakker NA, van Imhoff GW, Verschuuren EA, van Son WJ (2007) Presentation and early detection of post-transplant lymphoproliferative disorder after solid organ transplantation. Transpl Int 20:207–218PubMedCrossRef
47.
Jeon TY, Kim JH, Eo H, et al. (2010) Posttransplantation lymphoproliferative disorder in children: manifestations in hematopoietic cell recipients in comparison with liver recipients. Radiology 257:490–497PubMedCrossRef
48.
Levy M, Backman L, Husberg B, et al. (1993) De novo malignancy following liver transplantation: a single-center study. Transpl Proc 25:1397–1399
49.
50.
Pickhardt PJ, Siegel MJ (1999) Posttransplantation lymphoproliferative disorder of the abdomen: CT evaluation in 51 patients. Radiology 213:73–78PubMedCrossRef
51.
Blaes AH, Cioc AM, Froelich JW, Peterson BA, Dunitz JM (2009) Positron emission tomography scanning in the setting of post-transplant lymphoproliferative disorders. Clin Transpl 23:794–799CrossRef
52.
Chowdhury FU, Sheerin F, Bradley KM, Gleeson FV (2009) PET/CT staging and response evaluation of post-transplantation lymphoproliferative disease (PTLD). Clin Nucl Med 34:386–387PubMedCrossRef
53.
Lee EY, Anthony MP, Leung AY, Loong F, Khong PL (2012) Utility of FDG PET/CT in the assessment of myeloid sarcoma. AJR Am J Roentgenol 198:1175–1179PubMedCrossRef
54.
Mantzarides M, Bonardel G, Fagot T, et al. (2008) Granulocytic sarcomas evaluated with F-18-fluorodeoxyglucose PET. Clin Nucl Med 33:115–117PubMedCrossRef
55.
Neiman RS, Barcos M, Berard C, et al. (1981) Granulocytic sarcoma: a clinicopathologic study of 61 biopsied cases. Cancer 48:1426–1437PubMedCrossRef
56.
Shinagare AB, Krajewski KM, Hornick JL, et al. (2012) MRI for evaluation of myeloid sarcoma in adults: a single-institution 10-year experience. AJR Am J Roentgenol 199:1193–1198PubMedCrossRef
57.
Paydas S, Zorludemir S, Ergin M (2006) Granulocytic sarcoma: 32 cases and review of the literature. Leuk Lymphoma 47:2527–2541PubMedCrossRef
58.
Breccia M, D’Andrea M, Mengarelli A, et al. (2003) Granulocytic sarcoma of the pancreas successfully treated with intensive chemotherapy and stem cell transplantation. Eur J Haematol 70:190–192PubMedCrossRef
59.
Messager M, Amielh D, Chevallier C, Mariette C (2012) Isolated granulocytic sarcoma of the pancreas: a tricky diagnostic for primary pancreatic extramedullary acute myeloid leukemia. World J Surg Oncol 10:13PubMedCentralPubMedCrossRef
60.
Rong Y, Wang D, Lou W, Kuang T, Jin D (2010) Granulocytic sarcoma of the pancreas: a case report and review of the literatures. BMC Gastroenterol 10:80PubMedCentralPubMedCrossRef
61.
Choi EK, Byun JH, Lee SJ, et al. (2007) Imaging findings of leukemic involvement of the pancreaticobiliary system in adults. AJR Am J Roentgenol 188:1589–1595PubMedCrossRef
62.
Bakst R, Wolden S, Yahalom J (2012) Radiation therapy for chloroma (granulocytic sarcoma). Int J Radiat Oncol Biol Phys 82:1816–1822PubMedCrossRef
63.
64.
Hall MN, Jagannathan JP, Ramaiya NH, Shinagare AB, Van den Abbeele AD (2010) Imaging of extraosseous myeloma: CT, PET/CT, and MRI features. AJR Am J Roentgenol 195:1057–1065PubMedCrossRef
65.
Philips S, Menias C, Vikram R, Sunnapwar A, Prasad SR (2012) Abdominal manifestations of extraosseous myeloma: cross-sectional imaging spectrum. J Comput Assist Tomogr 36:207–212PubMedCrossRef
66.
Oshima K, Kanda Y, Nannya Y, et al. (2001) Clinical and pathologic findings in 52 consecutively autopsied cases with multiple myeloma. Am J Hematol 67:1–5PubMedCrossRef
67.
Varettoni M, Corso A, Pica G, et al. (2010) Incidence, presenting features and outcome of extramedullary disease in multiple myeloma: a longitudinal study on 1003 consecutive patients. Ann Oncol 21:325–330PubMedCrossRef
68.
Balliu E, Casas JD, Barluenga E, Guasch I (2003) Multifocal involvement of the pancreas in multiple myeloma: sonographic, CT, and MR imaging findings. AJR Am J Roentgenol 180:545–546PubMedCrossRef
69.
Gupta P, Rice GD, Abraham K, Ghole V, Ketkar M (2009) Extramedullary plasmacytoma of the pancreas and jejunum. Clin Imaging 33:240–243PubMedCrossRef
70.
Patlas M, Khalili K, Dill-Macky MJ, Wilson SR (2004) Spectrum of imaging findings in abdominal extraosseous myeloma. AJR Am J Roentgenol 183:929–932PubMedCrossRef
71.
Kazama T, Ng CS, Giralt SA (2005) Multiphasic CT and MRI appearances of extramedullary multiple myeloma involving the stomach, pancreas, and bladder. Clin Imaging 29:263–265PubMedCrossRef
72.
Birjawi GA, Jalbout R, Musallam KM, et al. (2008) Abdominal manifestations of multiple myeloma: a retrospective radiologic overview. Clin Lymphoma Myeloma 8:348–351PubMedCrossRef
73.
Kelekis NL, Semelka RC, Warshauer DM, Sallah S (1997) Nodular liver involvement in light chain multiple myeloma: appearance on US and MRI. Clin Imaging 21:207–209PubMedCrossRef
74.
Moulopoulos LA, Granfield CA, Dimopoulos MA, et al. (1993) Extraosseous multiple myeloma: imaging features. AJR Am J Roentgenol 161:1083–1087PubMedCrossRef
75.
Cerrato C, Palumbo A (2013) Initial treatment of nontransplant patients with multiple myeloma. Semin Oncol 40:577–584PubMedCrossRef
76.
77.
Girnius S, Munshi NC (2013) Individualized therapy in multiple myeloma: are we there? Semin Oncol 40:567–576PubMedCrossRef
78.
Moreau P, Touzeau C (2013) Initial treatment of transplant candidates with multiple myeloma. Semin Oncol 40:585–591PubMedCrossRef
79.
Bonekamp D, Horton KM, Hruban RH, Fishman EK (2011) Castleman disease: the great mimic. Radiographics 31:1793–1807PubMedCrossRef
80.
Herrada J, Cabanillas F, Rice L, Manning J, Pugh W (1998) The clinical behavior of localized and multicentric Castleman disease. Ann Intern Med 128:657–662PubMedCrossRef
81.
Cronin DM, Warnke RA (2009) Castleman disease: an update on classification and the spectrum of associated lesions. Adv Anat Pathol 16:236–246PubMedCrossRef
82.
McAdams HP, Rosado-de-Christenson M, Fishback NF, Templeton PA (1998) Castleman disease of the thorax: radiologic features with clinical and histopathologic correlation. Radiology 209:221–228PubMedCrossRef
83.
Charalabopoulos A, Misiakos EP, Foukas P, et al. (2010) Localized peripancreatic plasma cell Castleman disease. Am J Surg 199:e51–e53PubMedCrossRef
84.
Erkan N, Yildirim M, Selek E, Sayhan S (2004) Peripancreatic Castleman disease. JOP 5:491–494PubMed
85.
Tunru-Dinh VW, Ghani A, Tom YD (2007) Rare case of Castleman disease involving the pancreas. Am Surg 73:1284–1287PubMed
86.
Reddy D, Mitsuyasu R (2011) HIV-associated multicentric Castleman disease. Curr Opin Oncol 23:475–481PubMedCrossRef
87.
88.
Bandera B, Ainsworth C, Shikle J, Rupard E, Roach M (2010) Treatment of unicentric Castleman disease with neoadjuvant rituximab. Chest 138:1239–1241PubMedCrossRef
Metadata
Title
Hematologic malignancies of the pancreas
Authors
Kumar Sandrasegaran
Anderanik Tomasian
Khaled M. Elsayes
Harris Nageswaran
Akram Shaaban
Alampady Shanbhogue
Christine O. Menias
Publication date
01-02-2015
Publisher
Springer US
Published in
Abdominal Radiology / Issue 2/2015
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-014-0217-7

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