Abstract
Pancreatic involvement is an extremely rare manifestation of lymphoblastic lymphoma (LBL), and only a few cases have been reported. We report a case of LBL arising from the pancreas that was diagnosed using endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). The patient was a 57-year-old female who had suffered from abdominal pain for 2 weeks. A physical examination revealed an upper abdominal mass, but did not detect peripheral lymphadenopathy. Imaging studies including computed tomography (CT) and 18F-fluorodeoxy glucose (FDG)-positron emission tomography-CT revealed an enlarged pancreatic body, which was positive for FDG uptake. EUS-FNA detected medium-sized proliferating atypical lymphocytes, and immunohistochemical staining demonstrated that these cells were positive for CD20, CD10, PAX5, and terminal deoxynucleotidyl transferase. A bone marrow examination was negative for lymphoma infiltration, and a diagnosis of LBL arising from the pancreas was made. The patient was successfully treated with a combination of chemotherapy and pancreatic irradiation.
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References
Saif MW. Primary pancreatic lymphomas. JOP. 2006;7:262–73.
Mishra MV, Keith SW, Shen X, Bar Ad V, Champ CE, Biswas T. Primary pancreatic lymphoma: a population-based analysis using the SEER program. Am J Clin Oncol. 2013;36:38–43.
Daniel SV, Vani DH, Smith AM, Hill QA, Menon KV. Obstructive jaundice due to a pancreatic mass: a rare presentation of acute lymphoblastic leukaemia in an adult. JOP. 2010;11:72–4.
Yasuda I, Goto N, Tsurumi H, Nakashima M, Doi S, Iwashita T, et al. Endoscopic ultrasound-guided fine needle aspiration biopsy for diagnosis of lymphoproliferative disorders: feasibility of immunohistological, flow cytometric, and cytogenetic assessments. Am J Gastroenterol. 2012;107:397–404.
Behrns KE, Sarr MG, Strckler JG. Pancreatic lymphoma: is it a surgical disease? Pancreas. 1994;9:662–7.
Merkle EM, Bender GN, Brambs HJ. Imaging finding in pancreatic lymphoma: differential aspects. Am J Roentgenol. 2000;174:671–5.
Kotake F, Uno R, Takahashi Y. Computed tomography findings and diffusion-weighted magnetic resonance imaging of malignant lymphoma located mainly in the pancreas. J Tokyo Med Univ. 2009;67:43–51.
Nakaji S, Hirata N, Yoshimura S, Shiratori T, Kobayashi M, Ishii E. A case of primary pancreatic Burkitt’s lymphoma diagnosed by EUS-guided FNA. Gastrointest Endosc. 2013;77:958–9.
Yasuda I, Turumi H, Omar S, Iwashita T, Kojima Y, Yamada T, et al. Endoscopic ultrasound-guided fine-needle aspiration biopsy for lymphadenopathy of unknown origin. Endoscopy. 2006;38:919–24.
Nakahara O, Yamao K, Bhatia V, Sawaki A, Mizuno N, Takagi T, et al. Usefulness of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for undiagnosed intra-abdominal lymphadenopathy. J Gastroenterol. 2009;44:562–7.
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Conflict of Interest:
So Nakaji, Nobuto Hirata, Toshiyasu Shiratori, Masayoshi Kobayashi, Hiroyuki Fujii, Eiji Ishii and Kousei Matsue declare that they have no conflict of interest.
Human/Animal Rights:
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008(5).
Informed Consent:
Informed consent was obtained from all patients for being included in the study.
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Nakaji, S., Hirata, N., Shiratori, T. et al. A case of primary pancreatic lymphoblastic lymphoma diagnosed by endoscopic ultrasound-guided fine-needle aspiration . Clin J Gastroenterol 7, 180–184 (2014). https://doi.org/10.1007/s12328-014-0462-x
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DOI: https://doi.org/10.1007/s12328-014-0462-x