Matsubayashi Hiroyuki, Takagaki Shinichi, Otsubo Takao, Iiri Takao, Kobayashi Yuka, Yokota Takashi, Shichijo Kimitoshi, Iwafuchi Mitsuya, Kijima Hiroshi
Department of Gastroenterology, Tachikawa General Hospital, 3-2-11 Kanda-cho, Nagaoka 940-8621, Japan.
J Gastroenterol. 2002;37(10):863-7. doi: 10.1007/s005350200143.
An 82-year-old man was admitted to hospital with symptoms of abdominal fullness and loss of appetite. Abdominal computed tomography (CT) scan and ultrasonography showed enlargement of the whole pancreas with para-aortic lymphadenopathy. Endoscopic retrograde pancreatography (ERP) showed diffuse narrowing of the main pancreatic duct (MPD), and brushing cytology from the MPD was non-neoplastic. Differential diagnosis between lymphoma and other exocrine and endocrine pancreatic malignancies was needed, and the level of serum soluble interleukin-2 receptor (17 751 U/ml) was revealed to be significantly high, which was strongly suggestive of pancreatic lymphoma. Chemotherapy was refused by the patient's family and the patient succumbed after 2 months of conservative follow-up. Autopsy revealed diffuse, mixed cell-type, non-Hodgkin's lymphoma of T-cell subtype.
一名82岁男性因腹胀和食欲不振症状入院。腹部计算机断层扫描（CT）和超声检查显示整个胰腺肿大并伴有主动脉旁淋巴结病。内镜逆行胰胆管造影（ERP）显示主胰管（MPD）弥漫性狭窄，MPD刷检细胞学检查为非肿瘤性。需要对淋巴瘤与其他胰腺外分泌和内分泌恶性肿瘤进行鉴别诊断，结果显示血清可溶性白细胞介素-2受体水平显著升高（17 751 U/ml），强烈提示为胰腺淋巴瘤。患者家属拒绝化疗，患者在保守随访2个月后死亡。尸检显示为T细胞亚型的弥漫性、混合细胞型非霍奇金淋巴瘤。
