7
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Primary pancreatic lymphoma-diagnosed on computed tomography: A rare case report.

      case-report

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Primary pancreatic lymphoma is a rare disease. It comprises less than 0.5 % of pancreatic neoplasm and 0.1% of malignant lymphoma. It should be differentiated from pancreatic adenocarcinoma because management differs. At computed tomography, 2 types of morphology of primary pancreatic lymphoma have been described- a localized well-circumscribed tumoral form and another diffuse enlargement infiltrating or replacing most of the pancreatic gland. Here, we are presenting computed tomography (CT) imaging features of a case of primary pancreatic lymphoma in a 27 year old female who presented with a complaint of abdominal pain radiating to the back for 3 months and yellowish discoloration of sclera and skin for the last 15 days. In contrast-enhanced computed tomography an exophytic homogenously hypoenhancing mass arising from head and neck region of pancreas was seen. Involvement of common bile duct (CBD) and duodenum was there. The main pancreatic duct was not dilated. Common hepatic artery was encased by mass without arterial luminal narrowing or distortion. Diagnosis of primary pancreatic lymphoma was suggested on basis of imaging findings and further confirmed with fine-needle aspiration cytology.

          Related collections

          Most cited references8

          • Record: found
          • Abstract: found
          • Article: not found

          Imaging findings in pancreatic lymphoma: differential aspects.

          When the radiologist is faced with a well-circumscribed tumoral mass in the pancreas, knowing when to direct the patient toward nonsurgical biopsy instead of surgical biopsy and staging is critical. Lymphoma does not require surgical staging or a palliative Whipple's procedure before chemotherapy or radiation therapy. A better overall prognosis with nonsurgical treatment is additional impetus to search for secondary signs of primary pancreatic lymphoma. In patients with primary pancreatic lymphoma, no marked pancreatic ductal dilatation is present even with ductal invasion. Adenocarcinoma commonly dilates the more distal pancreatic duct when more proximal ductal invasion has taken place. Lymph node involvement below the level of the renal veins was another finding not seen with adenocarcinoma. Clinical and imaging findings are otherwise not specific in the differentiation of pancreatic lymphoma and pancreatic cancer, but a bulky homogeneous tumoral mass without alteration of Wirsung's duct or the peripancreatic vessels should suggest the diagnosis. In patients with diffuse infiltration of the pancreatic gland without clinical signs of pancreatitis, the radiologist should be alert to the possibility of pancreatic lymphoma.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Primary pancreatic lymphoma: Clinical presentation, diagnosis, treatment, and outcome.

            Primary pancreatic lymphoma (PPL) is a rare disease representing 0.1% of malignant lymphomas, which lacks well-defined diagnostic and therapeutic protocols.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: found
              Is Open Access

              CT imaging of primary pancreatic lymphoma: experience from three referral centres for pancreatic diseases

              Purpose To describe CT characteristics of primary pancreatic lymphoma (PPL), a rare disease with features in common with adenocarcinoma. Materials and methods Fourteen patients were enrolled. CT: unenhanced scan, contrast-enhanced pancreatic and venous phases. Image analysis: tumour location; peri-pancreatic vessel encasement; necrosis; enlarged lymph nodes; fat stranding; enlarged bile duct and pancreatic duct; neoplasm longest dimension, volume and density. Results Histopathological diagnoses: follicular non-Hodgkin lymphoma (5/14), diffuse large B-cell lymphoma (6/14) and high-grade B-cell lymphoma not otherwise specified (3/14). Six of 14 PPLs were located in the pancreatic head and 7/14 in the body-tail; 1/14 involved the whole gland. In 5/14 cases the superior mesenteric artery and vein were encased; splenic vein and artery encasement was depicted in 2 PPLs. Necrosis was present in 2/14. Enlarged retroperitoneal lymph nodes were found in 11 cases and fat stranding in all patients. The bile duct was dilated in six cases and the pancreatic duct in five. Mean neoplasm longest diameter and volume were 8.05 cm and 210.8 cm3. Mean tumour attenuation values were 39.1 HU at baseline, 60.6 HU in the pancreatic phase and 71.4 HU in the venous phase. Conclusions PPL presents as a large mass lesion with delayed homogeneous enhancement; peri-pancreatic fat stranding and vessel encasement are present, without vascular infiltration. Pancreatic duct dilatation is rare. Key points • Primary pancreatic lymphoma (PPL) is a rare haematological disease • PPL presents imaging features in common with pancreatic carcinoma but also some distinctive findings • The majority of PPLs are large lesions with delayed homogeneous enhancement • Peri-pancreatic fat stranding and vessel encasement are common in PPL • Vascular infiltration and pancreatic duct dilatation are rare in PPL
                Bookmark

                Author and article information

                Contributors
                Journal
                Radiol Case Rep
                Radiol Case Rep
                Radiology Case Reports
                Elsevier
                1930-0433
                04 April 2022
                June 2022
                04 April 2022
                : 17
                : 6
                : 1831-1835
                Affiliations
                [a ]Department of Radiodiagnosis, Dr. RMLIMS, Vibhuti Khand, Gomti Nagar, Lucknow, Uttar Pradesh, 226010, India
                [b ]Department of Surgical Oncology, Dr. RMLIMS, Vibhuti Khand, Gomti Nagar, Lucknow, Uttar Pradesh, 226010, India
                [c ]Department of Pathology, Dr. RMLIMS, Vibhuti Khand, Gomti Nagar, Lucknow, Uttar Pradesh, 226010, India
                Author notes
                [* ]Corresponding author. dr.rajlakshmi511@ 123456gmail.com
                Article
                S1930-0433(22)00145-5
                10.1016/j.radcr.2022.02.058
                8990050
                35401908
                7ae548c3-771a-41fb-afd0-fbc116c9c3d4
                © 2022 The Authors. Published by Elsevier Inc. on behalf of University of Washington.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 27 September 2021
                : 16 February 2022
                : 19 February 2022
                Categories
                Case Report

                primary pancreatic lymphoma,pancreatic lymphoma,computed tomography,ct- computed tomography, cbd- commomn bile duct,usg- ultrasonography, hu- hounsfield unit,pet- positron emission tomography, fnac- fine needle aspiration cytology

                Comments

                Comment on this article

                scite_
                0
                0
                0
                0
                Smart Citations
                0
                0
                0
                0
                Citing PublicationsSupportingMentioningContrasting
                View Citations

                See how this article has been cited at scite.ai

                scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.

                Similar content116

                Cited by4

                Most referenced authors83