Ravi Soundarya, Stephen S Norton, Gochhait Debasis, Potakkat Biju, Niranjani R, Siddaraju Neelaiah
Department of Pathology, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Dhanvantari Nagar, Puducherry, India.
Department of Surgical Gastroenterology, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Dhanvantari Nagar, Puducherry, India.
Diagn Cytopathol. 2020 Jan;48(1):57-60. doi: 10.1002/dc.24307. Epub 2019 Aug 24.
Primary pancreatic lymphoma (PPL) is an uncommon neoplasm which can clinico-radiologically mimic carcinoma. But the management of these patients differs from that of a carcinoma. Endoscopic ultrasound (EUS) guided fine-needle aspiration (FNA) serves as a potential tool to identify pancreatic lymphomas and thus prevent an invasive diagnostic test. This case report describes the presentation and diagnosis of primary pancreatic lymphoma. A 37-year-old female presented with nausea, vomiting with signs of icterus and elevated liver function test and Bilirubin. Abdominal computed tomography (CT) revealed a hypodense lesion in the head of the pancreas. EUS guided FNA was performed and cytological material was collected. The lesion was diagnosed as Non-Hodgkin Lymphoma (NHL) and subtyped as diffuse large B-cell lymphoma-germinal centre (DLBCL-GCB) base on immunohistochemistry on cell block. The patient was started on rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (RCHOP) regimen. EUS guided FNA along with ROSE, cell bock, and immunocytochemistry helps in the diagnosis of primary pancreatic lymphoma.
原发性胰腺淋巴瘤（PPL）是一种罕见的肿瘤，在临床放射学上可类似癌。但这些患者的治疗方法与癌不同。内镜超声（EUS）引导下细针穿刺抽吸活检（FNA）是识别胰腺淋巴瘤从而避免侵入性诊断检查的一种潜在工具。本病例报告描述了原发性胰腺淋巴瘤的临床表现及诊断。一名37岁女性出现恶心、呕吐，伴有黄疸体征以及肝功能检查和胆红素升高。腹部计算机断层扫描（CT）显示胰腺头部有一个低密度病变。进行了EUS引导下FNA并收集了细胞学材料。该病变被诊断为非霍奇金淋巴瘤（NHL），基于细胞块的免疫组织化学结果，亚型为弥漫性大B细胞淋巴瘤生发中心型（DLBCL-GCB）。患者开始接受利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松龙（RCHOP）方案治疗。EUS引导下FNA联合现场快速评估（ROSE）、细胞块和免疫细胞化学有助于原发性胰腺淋巴瘤的诊断。
