Sugishita Hiroki, Watanabe Yuji, Yamamoto Yuji, Yoshida Motohira, Sato Koichi, Horiuchi Atushi, Kawachi Kanji
Department of Organ Regenerative Surgery, Ehime University School of Medicine, Toon, Japan.
Case Rep Gastroenterol. 2010 Mar 17;4(1):104-110. doi: 10.1159/000283405.
Primary pancreatic lymphoma (PPL) is a rare disease that is difficult to diagnose preoperatively. We describe the youngest case of PPL treated by surgical excision and chemotherapy. A 16-year-old male presented with abdominal pain and jaundice. Abdominal computed tomography showed a 3.0 × 4.5 cm homogeneously enhanced mass localized between the inferior vena cava and pancreatic head; the common pancreatic duct was dilated and the common bile duct was stenosed. Magnetic resonance imaging findings showed a 4.5 cm tumor localized between the inferior vena cava and pancreatic head with low signal intensity on T1W images and high intensity on T2W images, which enhanced inhomogeneously. Endoscopic retrograde cholangiopancreatography findings were compatible with smooth stenosis of the common bile duct. He was diagnosed as pancreatitis secondary to pancreatic tumor and pylorus-preserving pancreaticoduodenectomy was performed. Postoperative diagnosis was PPL and chemotherapy was performed. After 4 years of treatment he has no signs of recurrence.
原发性胰腺淋巴瘤(PPL)是一种罕见疾病,术前难以诊断。我们描述了通过手术切除和化疗治疗的最年轻的PPL病例。一名16岁男性出现腹痛和黄疸。腹部计算机断层扫描显示,在肝下腔静脉和胰头之间有一个3.0×4.5厘米的均匀强化肿块;胰管扩张,胆总管狭窄。磁共振成像结果显示,在肝下腔静脉和胰头之间有一个4.5厘米的肿瘤,在T1加权图像上呈低信号强度,在T2加权图像上呈高信号强度,强化不均匀。内镜逆行胰胆管造影结果与胆总管平滑狭窄相符。他被诊断为胰腺肿瘤继发胰腺炎,并接受了保留幽门的胰十二指肠切除术。术后诊断为PPL,并进行了化疗。经过4年的治疗,他没有复发迹象。