Sallapan S, Abu Bakar N Z, Jarmin R, Masir N, Mohammed F
Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Pathology, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.
Malays J Pathol. 2018 Dec;40(3):359-371.
Primary pancreatic lymphomas are extremely rare. Clinically, primary pancreatic lymphoma mimics symptoms of carcinoma of the pancreatic head. Clinical and radiological features may overlap with other pancreatic conditions such as carcinoma, neuroendocrine tumours and autoimmune pancreatitis.
We report a case of a 75-year-old man who presented with symptoms of obstructive jaundice. Ultrasonography and computed tomography (CT) showed an ill-defined lobulated soft tissue lesion at the head/uncinate process of the pancreas measuring 4.5 x 4.9 x 5.8 cm. The patient underwent pancreaticoduodenectomy for suspected pancreatic head/uncinate process carcinoma. Histopathology and immunohistochemical assessment of the pancreatic lesion established the diagnosis of a low-grade follicular lymphoma.
Clinical and imaging features of primary pancreatic lymphoma may often overlap with pancreatic carcinoma. There is a value of obtaining preoperative tissue diagnosis such as tissue biopsy and fine needle aspiration (FNA) cytology with or without flow cytometry to make an accurate diagnosis of non-Hodgkin lymphoma and alleviate the need of more radical surgery in pancreatic lymphoma.
原发性胰腺淋巴瘤极为罕见。临床上,原发性胰腺淋巴瘤的症状与胰头癌相似。临床和影像学特征可能与其他胰腺疾病如胰腺癌、神经内分泌肿瘤和自身免疫性胰腺炎重叠。
我们报告一例75岁男性,表现为梗阻性黄疸症状。超声和计算机断层扫描(CT)显示胰腺头部/钩突处有一个边界不清的分叶状软组织病变,大小为4.5×4.9×5.8厘米。患者因疑似胰头/钩突癌接受了胰十二指肠切除术。胰腺病变的组织病理学和免疫组化评估确诊为低级别滤泡性淋巴瘤。
原发性胰腺淋巴瘤的临床和影像学特征常与胰腺癌重叠。术前进行组织诊断,如组织活检和细针穿刺(FNA)细胞学检查(有无流式细胞术)对于准确诊断非霍奇金淋巴瘤有价值,并且可以减少胰腺淋巴瘤患者进行更激进手术的必要性。