Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan.
Pancreatology. 2012 May-Jun;12(3):215-8. doi: 10.1016/j.pan.2012.02.011. Epub 2012 Feb 24.
Pancreatic pseudolymphoma is extremely rare.
We present multiple pseudolymphomas in the head and body of the pancreas. The hypoechoic lesions observed by endoscopic ultrasound were enhanced in late-phase angio-computed tomography and homogeneously hypointensive in T1-weighted magnetic resonance imaging (MRI). (18)F-fluorodeoxyglucose positron emission tomography showed strong accumulation in the lesions. The lesions were suspected to be non-functioning islet cell carcinoma. The intraoperative pathological diagnosis for the specimen obtained by a pylorus-preserving pancreaticoduodenectomy was non-neoplastic lymphoid cells. The remnant lesion in the pancreatic body was preserved.
Macroscopically, the mass was well-circumscribed gray-white colored lesion. The pathological diagnosis was pancreatic pseudolymphoma. The lesion in the remnant pancreas spontaneously disappeared within one year after the operation.
The differential diagnosis of pancreatic pseudolymphoma from malignant tumor is very difficult, however, the image findings demonstrated here may be informative. The spontaneous disappearance of pancreatic pseudolymphoma was firstly observed in the present case.
胰腺假性淋巴瘤非常罕见。
我们报告了多个发生于胰头部和体部的假性淋巴瘤。内镜超声观察到的低回声病变在晚期血管计算机断层扫描(angiogram CT)增强扫描时呈均匀强化,在 T1 加权磁共振成像(MRI)上呈均匀低信号。(18)F-氟代脱氧葡萄糖正电子发射断层扫描(FDG-PET)显示病变有强烈摄取。病变被怀疑为无功能胰岛细胞瘤。保留幽门的胰十二指肠切除术获得的标本术中病理诊断为非肿瘤性淋巴样细胞。胰体部的残余病变被保留。
大体上,肿块为边界清楚的灰白色病变。病理诊断为胰腺假性淋巴瘤。术后 1 年内,残留胰腺的病变自行消失。
胰腺假性淋巴瘤与恶性肿瘤的鉴别诊断非常困难,但此处显示的影像学表现可能具有提示作用。本病例首次观察到胰腺假性淋巴瘤的自发消失。