Shah Raj, Asif Talal, Johnson Richard
Department of Internal Medicine, University of Missouri Kansas city.
Department of Internal Medicine, University of Missouri Kansas City.
Cureus. 2017 Feb 9;9(2):e1019. doi: 10.7759/cureus.1019.
()-filled pancreatic masses are a rarely reported entity. Furthermore, there are only a few case reports in literature on the association of these masses with cancer. We present a case of a filled pancreatic cystic mass in a patient with a history of T-cell-rich B-cell lymphoma. The authors performed a PubMed search using (Medical Subject Headings) MeSH terms of pancreas, mass, , and lymphoma. A 53-year-old male with past medical and surgical history of T-cell-rich B-cell lymphoma, status post R-CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone plus rituximab) therapy with positron emission tomography (PET) scan showing no residual disease, essential hypertension, and alcohol use disorder presented to the emergency department (ED) with epigastric pain and nausea for one week. Computed tomography (CT) scan of the abdomen showed a 2.3 cm hypodense pancreatic cystic mass. This was a new finding when compared to his prior abdominal imaging. Fine needle aspiration (FNA) biopsy of the mass showed lymphocytes, reactive atypical epithelial cells, and numerous organisms consistent with . He was treated with metronidazole 250 mg by mouth three times a day (TID) for five days. Follow-up magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP) showed complete resolution of the pancreatic mass. There are only a few case reports on in the pancreas. The pathologist indicated sheets of numerous in the sample, making small bowel contamination less likely and aspirate from the pancreas more probable as the source. The authors hypothesize that this patient may have had chronic infection as a potential cause for the T-cell-rich B-cell lymphoma manifestation. The patient reported travel to an area with possible exposure to one year prior to presentation with the lymphoma. During that time he had increasing abdominal pain, intermittent chronic diarrhea, and weight loss. mechanism of action has been theorized to involve induction of pro-apoptotic factors, intestinal barrier dysfunction, up-regulation of cell-cycle genes, and crypt hyperplasia. The mechanism of action of pancreatic masses filled with and the association of and cancer is not completely understood. Further research is required to better understand these possible phenomena as it can help us better comprehend , its associations, and new cancer etiologies.
充满（某种物质）的胰腺肿块是一种鲜有报道的实体。此外，文献中仅有少数关于这些肿块与癌症关联的病例报告。我们报告一例有富含T细胞的B细胞淋巴瘤病史患者的充满（某种物质）的胰腺囊性肿块病例。作者使用胰腺、肿块、（某种物质）和淋巴瘤的医学主题词（MeSH）在PubMed上进行了检索。一名53岁男性，有富含T细胞的B细胞淋巴瘤的既往病史和手术史，接受R-CHOP（环磷酰胺、阿霉素、长春新碱、泼尼松加利妥昔单抗）治疗后正电子发射断层扫描（PET）显示无残留疾病，有原发性高血压和酒精使用障碍，因上腹部疼痛和恶心一周就诊于急诊科（ED）。腹部计算机断层扫描（CT）显示一个2.3厘米的低密度胰腺囊性肿块。与他之前的腹部影像学检查相比，这是一个新发现。肿块的细针穿刺抽吸（FNA）活检显示淋巴细胞、反应性非典型上皮细胞和许多与（某种物质）一致的生物体。他接受了甲硝唑250毫克口服，每日三次，共五天的治疗。随访磁共振成像（MRI）和磁共振胰胆管造影（MRCP）显示胰腺肿块完全消退。胰腺中关于（某种物质）的病例报告仅有少数。病理学家指出样本中有大量（某种物质）的片状物，使小肠污染的可能性较小，而从胰腺抽吸到（某种物质）的可能性更大，以此作为来源。作者推测该患者可能有慢性（某种物质）感染，这是富含T细胞的B细胞淋巴瘤表现的潜在原因。患者报告在出现淋巴瘤前一年前往可能接触（某种物质）的地区。在此期间，他的腹痛加剧，有间歇性慢性腹泻和体重减轻。（某种物质）的作用机制据推测涉及促凋亡因子的诱导、肠屏障功能障碍、细胞周期基因的上调和隐窝增生。充满（某种物质）的胰腺肿块的作用机制以及（某种物质）与癌症的关联尚未完全明了。需要进一步研究以更好地理解这些可能的现象，因为这有助于我们更好地理解（某种物质）及其关联以及新的癌症病因。
