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Published in: Journal of Medical Case Reports 1/2008

Open Access 01-12-2008 | Case report

A role for surgery in primary pancreatic B-cell lymphoma: a case report

Authors: Theodore Liakakos, Evangelos P Misiakos, Dimitrios Tsapralis, Irene Nikolaou, Gabriel Karatzas, Anastasios Macheras

Published in: Journal of Medical Case Reports | Issue 1/2008

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Abstract

Introduction

Primary pancreatic lymphoma is a very rare but manageable malignant tumour which may be clinically confused as a pancreatic carcinoma. This case report demonstrates the value of surgical resection in the management of pancreatic lymphoma.

Case presentation

We report a case of a 65-year-old man who was admitted with obstructive jaundice, vague upper abdominal pain and weight loss. Ultrasonography and computed tomography showed a mass at the head of the pancreas which was compressing the bile duct. The patient underwent pancreaticoduodenectomy. Histopathologic and immunohistochemical assessment of the pancreatic lesion established the diagnosis of a diffuse, extranodal, high-grade B-cell non-Hodgkin's lymphoma. Several doses of chemotherapy were administered postoperatively and at present the disease remains in remission.

Conclusion

The favourable outcome for this patient and a thorough review of the literature underline the important role that operative resection may have in the management of at least the early stage of primary pancreatic lymphoma.
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Literature
1.
go back to reference Zucca E, Roggero E, Bertoni F, Cavalli F: Primary extranodal non-Hodgkin's lymphomas. Part 1: Gastrointestinal, cutaneous and genitourinary lymphomas. Ann Oncol. 1997, 8: 727-737. 10.1023/A:1008282818705.CrossRefPubMed Zucca E, Roggero E, Bertoni F, Cavalli F: Primary extranodal non-Hodgkin's lymphomas. Part 1: Gastrointestinal, cutaneous and genitourinary lymphomas. Ann Oncol. 1997, 8: 727-737. 10.1023/A:1008282818705.CrossRefPubMed
2.
go back to reference Koniaris LG, Lillemoe KD, Yeo CJ, Abrams RA, Colemann J, Nakeeb A, Pitt H, Cameron JL: Is there a role for surgical resection in the treatment of early-stage pancreatic lymphoma?. J Am Coll Surg. 2000, 190: 319-330. 10.1016/S1072-7515(99)00291-4.CrossRefPubMed Koniaris LG, Lillemoe KD, Yeo CJ, Abrams RA, Colemann J, Nakeeb A, Pitt H, Cameron JL: Is there a role for surgical resection in the treatment of early-stage pancreatic lymphoma?. J Am Coll Surg. 2000, 190: 319-330. 10.1016/S1072-7515(99)00291-4.CrossRefPubMed
3.
go back to reference Behrns KE, Sarr MG, Strickler JC: Pancreatic lymphoma: is it a surgical disease?. Pancreas. 1994, 9: 662-667. 10.1097/00006676-199409000-00019.CrossRefPubMed Behrns KE, Sarr MG, Strickler JC: Pancreatic lymphoma: is it a surgical disease?. Pancreas. 1994, 9: 662-667. 10.1097/00006676-199409000-00019.CrossRefPubMed
4.
go back to reference Islam S, Callery MP: Primary pancreatic lymphoma – a diagnosis to remember. Surgery. 2001, 129: 380-382. 10.1067/msy.2001.113284.CrossRefPubMed Islam S, Callery MP: Primary pancreatic lymphoma – a diagnosis to remember. Surgery. 2001, 129: 380-382. 10.1067/msy.2001.113284.CrossRefPubMed
5.
go back to reference Nayer H, Weir E, Sheth S, Ali S: Primary pancreatic lymphomas. A cytopathologic analysis of a rare malignancy. Cancer. 2004, 102: 315-321. 10.1002/cncr.20488.CrossRefPubMed Nayer H, Weir E, Sheth S, Ali S: Primary pancreatic lymphomas. A cytopathologic analysis of a rare malignancy. Cancer. 2004, 102: 315-321. 10.1002/cncr.20488.CrossRefPubMed
6.
go back to reference Fisher RI, Gaynor ER, Dahlebrg S: Comparison of a standard regimen (CHOP) with three intensive chemotherapy regimens for advanced non-Hodgkin's lymphoma. N Engl J Med. 1993, 328: 1002-1006. 10.1056/NEJM199304083281404.CrossRefPubMed Fisher RI, Gaynor ER, Dahlebrg S: Comparison of a standard regimen (CHOP) with three intensive chemotherapy regimens for advanced non-Hodgkin's lymphoma. N Engl J Med. 1993, 328: 1002-1006. 10.1056/NEJM199304083281404.CrossRefPubMed
7.
go back to reference Talamonti MS, Dawes LG, Joehl RJ: Gastrointestinal lymphoma. A case for primary surgical resection. Arch Surg. 1990, 125: 972-976.CrossRefPubMed Talamonti MS, Dawes LG, Joehl RJ: Gastrointestinal lymphoma. A case for primary surgical resection. Arch Surg. 1990, 125: 972-976.CrossRefPubMed
8.
go back to reference Rappaport H: Tumors of the hematopoietic system. Atlas of tumor pathology, section 3, fascile 8. 1996, Washington DC: Armed Forces Institute of Pathology Rappaport H: Tumors of the hematopoietic system. Atlas of tumor pathology, section 3, fascile 8. 1996, Washington DC: Armed Forces Institute of Pathology
9.
go back to reference The Non-Hodgkin's Lymphoma Pathologic Classification Project: National Cancer Institute sponsored study of classifications of non-Hodgkin's lymphomas: summary and description of a working formulation for clinical usage. Cancer. 1982, 49: 2112-2135. 10.1002/1097-0142(19820515)49:10<2112::AID-CNCR2820491024>3.0.CO;2-2.CrossRef The Non-Hodgkin's Lymphoma Pathologic Classification Project: National Cancer Institute sponsored study of classifications of non-Hodgkin's lymphomas: summary and description of a working formulation for clinical usage. Cancer. 1982, 49: 2112-2135. 10.1002/1097-0142(19820515)49:10<2112::AID-CNCR2820491024>3.0.CO;2-2.CrossRef
10.
go back to reference Grimison PS, Chin MT, Harrison ML, Goldstein D: Primary pancreatic lymphoma-pancreatic tumors that are potentially curable without resection, a retrospective review of four cases. BMC Cancer. 2006, 6: 117-125. 10.1186/1471-2407-6-117.CrossRefPubMedPubMedCentral Grimison PS, Chin MT, Harrison ML, Goldstein D: Primary pancreatic lymphoma-pancreatic tumors that are potentially curable without resection, a retrospective review of four cases. BMC Cancer. 2006, 6: 117-125. 10.1186/1471-2407-6-117.CrossRefPubMedPubMedCentral
12.
go back to reference Savopoulos CG, Tsesmeli NE, Kaiafa GD, Zantidis AT, Bobos MT, Hatzitolios AI, Papavramidis ST, Kostopoulos IS: Primary pancreatic anaplastic large cell lymphoma, ALK negative: A case report. World J Gastroenterol. 2005, 11: 6221-6224.CrossRefPubMedPubMedCentral Savopoulos CG, Tsesmeli NE, Kaiafa GD, Zantidis AT, Bobos MT, Hatzitolios AI, Papavramidis ST, Kostopoulos IS: Primary pancreatic anaplastic large cell lymphoma, ALK negative: A case report. World J Gastroenterol. 2005, 11: 6221-6224.CrossRefPubMedPubMedCentral
13.
go back to reference Arcari A, Anselmi E, Bernuzzi P, Berte R, Lazzaro A, Moroni CF, Trabacchi E, Vallisa D, Vercelli A, Cavanna L: Primary pancreatic lymphoma. Report of five cases. Haematologica. 2005, 90 (1): ERC09- Arcari A, Anselmi E, Bernuzzi P, Berte R, Lazzaro A, Moroni CF, Trabacchi E, Vallisa D, Vercelli A, Cavanna L: Primary pancreatic lymphoma. Report of five cases. Haematologica. 2005, 90 (1): ERC09-
14.
go back to reference Merkle EM, Bender GN, Brams HJ: Imaging findings in pancreatic lymphoma: differential aspects. AJR Am J Roentgenol. 2000, 174: 671-675.CrossRefPubMed Merkle EM, Bender GN, Brams HJ: Imaging findings in pancreatic lymphoma: differential aspects. AJR Am J Roentgenol. 2000, 174: 671-675.CrossRefPubMed
15.
go back to reference Kang M, Kochhar R, Gulati M, Suri S: Pancreatic lymphoma: atypical imaging findings. Indian J Gastroenterol. 2006, 25: 50-PubMed Kang M, Kochhar R, Gulati M, Suri S: Pancreatic lymphoma: atypical imaging findings. Indian J Gastroenterol. 2006, 25: 50-PubMed
16.
go back to reference Volmar KE, Routbort MJ, Jones CK, Xie HB: Primary pancreatic lymphoma evaluated by fine-needle aspiration: findings in 14 cases. Am J Clin Pathol. 2004, 121: 898-903. 10.1309/UAD9-PYFU-A82X-9R9U.CrossRefPubMed Volmar KE, Routbort MJ, Jones CK, Xie HB: Primary pancreatic lymphoma evaluated by fine-needle aspiration: findings in 14 cases. Am J Clin Pathol. 2004, 121: 898-903. 10.1309/UAD9-PYFU-A82X-9R9U.CrossRefPubMed
17.
go back to reference Nishimura R, Takakuwa T, Hoshida Y, Tsujimoto M, Aozasa K: Primary pancreatic lymphoma: clinicopathological analysis of 19 cases from Japan and review of the literature. Oncology. 2001, 60: 322-329. 10.1159/000058528.CrossRefPubMed Nishimura R, Takakuwa T, Hoshida Y, Tsujimoto M, Aozasa K: Primary pancreatic lymphoma: clinicopathological analysis of 19 cases from Japan and review of the literature. Oncology. 2001, 60: 322-329. 10.1159/000058528.CrossRefPubMed
Metadata
Title
A role for surgery in primary pancreatic B-cell lymphoma: a case report
Authors
Theodore Liakakos
Evangelos P Misiakos
Dimitrios Tsapralis
Irene Nikolaou
Gabriel Karatzas
Anastasios Macheras
Publication date
01-12-2008
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2008
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/1752-1947-2-167

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