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Diagnostic dilemma in pancreatic lymphoma

Case report and review

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Summary

Non-Hodgkin's lymphoma predominantly involving the pancreas is a rare tumor of the gastrointestinal tract. Diagnosis can be difficult, since lymphoma may mimic carcinoma or pancreatitis. Lymphoproliferative diseases induced by immunosuppressive therapy frequently occur in the gastrointestinal tract of posttransplant patients. However, pancreatic involvement of posttransplant lymphoma is an exceptional condition. We present the case of a cyclosporin-treated renal transplant recipient with pancreatic lymphoma mimicking carcinomatous or inflammatory tumors. The diagnostic difficulties and treatment options of pancreatic lymphoma as well as lymphoproliferative disorders in immunosuppressed renal recipients are discussed in light of the current literature.

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References

  1. Webb TH, Lillemoe KD, Pitt HA, et al. Pancreatic lymphoma: is surgery mandatory for diagnosis and treatment?Ann Surg 1989; 209: 25–30.

    Article  PubMed  CAS  Google Scholar 

  2. Baylor SM, Berg JW. Cross-classification of survival characteristics of 5,000 cases of cancer of the pancreas.J Surg Oncol 1973; 5: 335–358.

    Article  PubMed  CAS  Google Scholar 

  3. Penn I, Starzl TE. Malignant tumors arising de novo in immunosuppressed organ transplant recipients.Transplantation 1972; 14: 407–417.

    Article  PubMed  CAS  Google Scholar 

  4. Cockburn I. Assessment of the risks of malignancy and lymphomas developing in patients using sandimmune.Transplant Proc 1987; 19: 1804–1807.

    PubMed  CAS  Google Scholar 

  5. Penn I. Malignant lymphomas in organ transplant recipients.Transplant Proc 1981; 13: 736–738.

    PubMed  CAS  Google Scholar 

  6. Tubman DE, Frick MP, Hanto DW. Lymphoma after organ transplantation: radiologic manifestations in the central nervous system, thorax and abdomen.Radiology 1983; 149: 625–631.

    PubMed  CAS  Google Scholar 

  7. Bonacini M. Pancreatic involvement in human immunodeficiency virus infection.J Clin Gastroenterol 1991; 13: 58–64.

    Article  PubMed  CAS  Google Scholar 

  8. Radin DR, Esplin JA, Levine AM, et al. Aids-related non-Hodgkin's lymphoma: abdominal CT findings in 112 patients.AJR 1993; 160: 1133–1139.

    PubMed  CAS  Google Scholar 

  9. Ackerman NB, Aust JC, Bredenberg CE, et al. Problems in differentiating between pancreatic lymphoma and anaplastic carcinoma and their management.Ann Surg 1976; 184: 705–708.

    Article  PubMed  CAS  Google Scholar 

  10. Safadi R, Or R, Bar Ziv J, et al. Lymphoma-associated pancreatitis as a presenting manifestation of immunoblastic lymphoma.Leuk Lymph 1994; 12: 317–319.

    Article  CAS  Google Scholar 

  11. Kotwall CA, Brow JR, Keith RG. Lymphoma pancreatitis: a real entity.Can J Surg 1989; 32: 375–377.

    PubMed  CAS  Google Scholar 

  12. Cappell MS, Yao F, Cho KC, et al. Lymphoma predominantly involving the pancreas.Dig Dis Sci 1989; 34: 942–947.

    Article  PubMed  CAS  Google Scholar 

  13. Tuchek JM, De Jong SA, Pickleman J. Diagnosis, surgical intervention, and prognosis of primary pancreatic lymphoma.Am Surg 1993; 59: 513–518.

    PubMed  CAS  Google Scholar 

  14. Shtamler B, Bickel A, Manor E, et al. Primary lymphoma of the head of the pancreas.J Surg Oncol 1988; 38: 48–51.

    Article  PubMed  CAS  Google Scholar 

  15. Behrns KE, Sarr MG, Strickler JG. Pancreatic lymphoma: is it a surgical disease?Pancreas 1994; 9: 662–667.

    Article  PubMed  CAS  Google Scholar 

  16. Borrowdale R, Strong RW. Primary lymphoma of the pancreas.Aust NZ J Surg 1994; 64: 444–446.

    Article  CAS  Google Scholar 

  17. Scully RE, Mark EJ, McNeely BU. Case records of the Massachusetts General Hospital. Weekly Clinicopathological Exercises. Case 11–85.N Engl J Med 1985; 312: 706–711.

    Article  Google Scholar 

  18. Prayer L, Schurawitzki H, Mallek R, et al. CT in pancreatic involvement of non-Hodgkin lymphoma.Acta Radiol 1992; 33: 123–127.

    Article  PubMed  CAS  Google Scholar 

  19. Joly I, David A, Payan MJ, et al. A case of primary non-Hodgkin lymphoma of the pancreas.Pancreas 1992; 7: 118–120.

    Article  PubMed  CAS  Google Scholar 

  20. Teefey SA, Stephens DH, Sheedy PF. CT appearance of primary pancreatic lymphoma.Gastrointest Radiol 1986; 11: 41–43.

    Article  PubMed  CAS  Google Scholar 

  21. Ng YY, Healy JC, Vincent JM, et al. The radiology of non-Hodgkin's lymphoma in childhood: a review of 80 cases.Clin Radiol 1994; 49: 594–600.

    Article  PubMed  CAS  Google Scholar 

  22. Dodd GD III, Greenler DP, Confer SR. Thoracic and abdominal manifestations of lymphoma occuring in the immunocompromised patient.Radiol Clin North Am 1992; 30: 597–610.

    PubMed  Google Scholar 

  23. Palazzo L, Rouseau G, Gayet B, et al. Endoscopic ultrasonography in the diagnosis and staging of pancreatic adenocarcinoma.Endoscopy 1993; 25: 143–150.

    Article  PubMed  CAS  Google Scholar 

  24. Tikkakoski T, Siniluoto T, Päiivänsalo M, et al. Diagnostic accuracy of ultrasound-guided fine-needle pancreatic biopsy.Fortschr. Röntgenstr 1992; 156: 178–181.

    Article  CAS  Google Scholar 

  25. Dinkel E, Helwig A, Jäger B, et al. Computer tomographyguided fine-needle biopsy of the pancreas for histological purposes.Radiologe 1990; 30: 420–424.

    PubMed  CAS  Google Scholar 

  26. Brown PC, Hart MJ, White TT. Pancreatic lymphoma, diagnosis and management.Int J Pancreatol 1987; 2: 93–100.

    PubMed  CAS  Google Scholar 

  27. Fischer MG, Kabakow B. Lymphoma of the pancreas.Mt Sinai J Med 1987; 54: 423–426.

    PubMed  CAS  Google Scholar 

  28. Rodriguez J, Kasberg C, Nipper M, et al. CT-guided needle biopsy of the pancreas: a retrospective analysis of diagnostic accuracy.Am J Gastroenterol 1992; 87: 1610–1613.

    PubMed  CAS  Google Scholar 

  29. Hu E, Horning S, Flynn S, et al. Diagnosis of B cell lymphoma by analysis of immunoglobulin gene rearrangements in biopsy specimens obtained by fine needle aspiration.J Clin Oncol 1986; 4: 278–283.

    PubMed  CAS  Google Scholar 

  30. Pinto MM, Levine RH. Carcinoembryonic antigen assay in fine needle aspirate of pancreas: a diagnostic adjunct to cytology.Am J Gastroenterol 1992; 87: 530–533.

    PubMed  CAS  Google Scholar 

  31. Hart MJ, White TT, Brown PC, et al. Potentially curable masses in the pancreas.Am J Surg 1987; 154: 134–136.

    Article  PubMed  CAS  Google Scholar 

  32. Pasanen PA, Eskelinen M, Vornanen M, et al. Pancreatic lymphoma.Ann Chir Gynaecol 1993; 82: 207–209.

    PubMed  CAS  Google Scholar 

  33. Gawdat K, Howe K. Pancreatic lymphoma.J Clin Gastroenterol 1993; 16: 258–260.

    PubMed  CAS  Google Scholar 

  34. Yusuf SW, Harrison JD, Manhire AR, et al. Primary B-cell immunoblastic lymphoma of pancreas.Eur J Surg Oncol 1991; 17: 555–557.

    PubMed  CAS  Google Scholar 

  35. Summary of Pancreas Club Meeting.Am J Surg 1992; 164: 311–315.

    Google Scholar 

  36. Starzl TE, Porter KA, Iwatsuki S, et al. Reversibility of lymphomas and lymphoproliferative lesions developing under cyclosporin-steroid therapy.Lancet 1984; I: 583–587.

    Article  Google Scholar 

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Cario, E., Rünzi, M., Metz, K. et al. Diagnostic dilemma in pancreatic lymphoma. Int J Gastrointest Canc 22, 67–71 (1997). https://doi.org/10.1007/BF02803907

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  • DOI: https://doi.org/10.1007/BF02803907

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