Raj Mithun, Ghoshal Uday C, Choudhuri Gourdas, Mohindra Samir
Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences. Lucknow, India.
JOP. 2013 Jul 10;14(4):463-5. doi: 10.6092/1590-8577/1186.
Diffuse large B-cell lymphoma is the commonest form of non-Hodgkin lymphoma. Gastro-intestinal tract and bone marrow are common extra-nodal sites of lymphomatous involvement.
A 54-year-old woman presented with acute onset epigastric pain. On evaluation, raised serum amylase and radiological features of acute pancreatitis were detected. Gastroscopy revealed thickened folds in distal stomach, which on histopathology revealed large B-cell lymphoma. Subsequently, the patient developed extra-hepatic biliary obstruction due to peripancreatic lymph nodal mass that was relieved with plastic biliary stenting. Subsequent chemotherapy regime directed against lymphoma led to resolution of lymphoma.
In this patient , pancreatitis was the initial presentation of primary gastric lymphoma, which has not been commonly reported and therefore should be considered in the etiological workup.
弥漫性大B细胞淋巴瘤是非霍奇金淋巴瘤最常见的形式。胃肠道和骨髓是淋巴瘤累及的常见结外部位。
一名54岁女性因突发上腹部疼痛就诊。评估发现血清淀粉酶升高及急性胰腺炎的影像学特征。胃镜检查显示胃远端皱襞增厚,组织病理学检查显示为大B细胞淋巴瘤。随后,患者因胰周淋巴结肿块导致肝外胆管梗阻,通过放置塑料胆管支架得以缓解。随后针对淋巴瘤的化疗方案使淋巴瘤消退。
在该患者中,胰腺炎是原发性胃淋巴瘤的首发表现,这种情况尚未见常见报道,因此在病因检查中应予以考虑。