Wang Yu Jen, Jeng Chin Ming, Wang Young Chen, Chang Pi Peng, Wang Tsung His
Department of Radiology, Cathay General Hospital, 18 Hsinhai Road, Pan Chiao City, Taipei Hsien 220, Taiwan, ROC.
Eur J Gastroenterol Hepatol. 2006 May;18(5):537-40. doi: 10.1097/00042737-200605000-00014.
Primary pancreatic lymphoma is a rare neoplasm. We report the case of a 49-year-old man who presented with biliary obstruction due to a neoplasm involving the pancreatic head. Initial computed tomography revealed a suspicious periampullary mass. Consequently, magnetic resonance imaging was performed 16 days later, showing a relatively clearly defined and homogeneous signal mass in the pancreatic head with biliary dilatation on enhanced study. In combination with high tumour marker associated antigen CA19-9 levels (1872 and 2110 U/ml), these findings were highly suggestive of a pancreatic carcinoma. He underwent Whipple's procedure. Examination of the surgical specimen revealed a Burkitt's lymphoma. This case demonstrates that lymphoma can present with features mimicking pancreatic head carcinoma on imaging, clinical and laboratory studies. Neither clinical nor imaging nor laboratory methods indicate correct diagnosis, but a relatively clearly defined and homogeneous mass should prompt the physician to include lymphoma in a differential diagnosis of a pancreatic mass.
原发性胰腺淋巴瘤是一种罕见的肿瘤。我们报告一例49岁男性，因肿瘤累及胰头导致胆道梗阻。最初的计算机断层扫描显示壶腹周围有可疑肿块。因此，16天后进行了磁共振成像，增强扫描显示胰头有一个相对边界清晰且信号均匀的肿块，伴有胆道扩张。结合高肿瘤标志物相关抗原CA19-9水平（1872和2110 U/ml），这些发现高度提示胰腺癌。他接受了惠普尔手术。手术标本检查显示为伯基特淋巴瘤。该病例表明，淋巴瘤在影像学、临床和实验室检查中可表现出类似胰头癌的特征。临床、影像学和实验室方法均不能明确诊断，但相对边界清晰且信号均匀的肿块应促使医生在胰腺肿块的鉴别诊断中考虑淋巴瘤。
