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04-01-2016 | Pancreatic cancer | Article

Current update on primary pancreatic lymphoma

Journal: Abdominal Radiology

Authors: Deepa Anand, Chandana Lall, Priya Bhosale, Dhakshinamoorthy Ganeshan, Aliya Qayyum

Abstract

Objective

This article reviews the computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) CT findings of primary and secondary pancreatic lymphomas and discusses the role of endoscopic ultrasound-guided fine needle aspiration in diagnosis and management.

Conclusion

Pancreatic lymphoma has certain characteristic imaging features which may help distinguish it from the more common pancreatic adenocarcinoma. It is critical to make an accurate diagnosis, as the management of these two conditions is vastly different.

Behrns KE, Sarr MG, Strickler JG (1994) Pancreatic lymphoma: is it a surgical disease? Pancreas 9(5):662–667CrossRefPubMed

Hamilton SR, Aaltonen AL (eds) (2000) World Health Organization classification of tumours. Pathology and genetics of tumours of the digestive system. Lyon: IARC Press

Sadot E, Yahalom J, Do RK, et al. (2015) Clinical features and outcome of primary pancreatic lymphoma. Ann Surg Oncol 22(4):1176–1184. doi:10.1245/s10434-014-4176-6 CrossRefPubMed

Cario E, Runzi M, Metz K, Layer P, Goebell H (1997) Diagnostic dilemma in pancreatic lymphoma. Case report and review. Int J Pancreatol 22(1):67–71. doi:10.1007/bf02803907 CrossRefPubMed

Joly I, David A, Payan MJ, Sahel J, Sarles H (1992) A case of primary non-Hodgkin lymphoma of the pancreas. Pancreas 7(1):118–120CrossRefPubMed

Neef B, Kunzig B, Sinn I, Kieninger G, von Gaisberg U (1997) Primary pancreatic lymphoma. A rare cause of pain-free icterus. Dtsch Med Wochenschr 122(1–2):12–17. doi:10.1055/s-2008-1047570 CrossRefPubMed

Teefey SA, Stephens DH, Sheedy PF 2nd (1986) CT appearance of primary pancreatic lymphoma. Gastrointest Radiol 11(1):41–43. doi:10.1007/bf02035029 CrossRefPubMed

Tuchek JM, De Jong SA, Pickleman J (1993) Diagnosis, surgical intervention, and prognosis of primary pancreatic lymphoma. Am Surg 59(8):513–518PubMed

Baylor SM, Berg JW (1973) Cross-classification and survival characteristics of 5000 cases of cancer of the pancreas. J Surg Oncol 5(4):335–358CrossRefPubMed

10.

Mishra MV, Keith SW, Shen X, et al. (2013) Primary pancreatic lymphoma: a population-based analysis using the SEER program. Am J Clin Oncol 36(1):38–43. doi:10.1097/COC.0b013e3182354bbb CrossRefPubMed

11.

Jones WF, Sheikh MY, McClave SA (1997) AIDS-related non-Hodgkin’s lymphoma of the pancreas. Am J Gastroenterol 92(2):335–338PubMed

12.

Johnson EA, Benson ME, Guda N, et al. (2014) Differentiating primary pancreatic lymphoma from adenocarcinoma using endoscopic ultrasound characteristics and flow cytometry: A case-control study. Endosc Ultrasound 3(4):221–225. doi:10.4103/2303-9027.144530 PubMedCentralCrossRefPubMed

13.

Merkle EM, Bender GN, Brambs HJ (2000) Imaging findings in pancreatic lymphoma: differential aspects. AJR Am J Roentgenol 174(3):671–675. doi:10.2214/ajr.174.3.1740671 CrossRefPubMed

14.

Maruyama H, Nakatsuji N, Sugihara S, et al. (1997) Anaplastic Ki-1-positive large cell lymphoma of the pancreas: a case report and review of the literature. Jpn J Clin Oncol 27(1):51–57CrossRefPubMed

15.

Kalra MK, Maher MM, Mueller PR, Saini S (2003) State-of-the-art imaging of pancreatic neoplasms. Br J Radiol 76(912):857–865. doi:10.1259/bjr/16642775 CrossRefPubMed

16.

Basu A, Patil N, Mohindra P, et al. (2007) Isolated non-Hodgkin’s lymphoma of the pancreas: case report and review of literature. J Cancer Res Ther 3(4):236–239CrossRefPubMed

17.

Battula N, Srinivasan P, Prachalias A, Rela M, Heaton N (2006) Primary pancreatic lymphoma: diagnostic and therapeutic dilemma. Pancreas 33(2):192–194. doi:10.1097/01.mpa.0000227910.63579.15 CrossRefPubMed

18.

Boni L, Benevento A, Dionigi G, Cabrini L, Dionigi R (2002) Primary pancreatic lymphoma. Surg Endosc 16(7):1107–1108. doi:10.1007/s00464-001-4247-1 CrossRefPubMed

19.

Grimison PS, Chin MT, Harrison ML, Goldstein D (2006) Primary pancreatic lymphoma–pancreatic tumours that are potentially curable without resection, a retrospective review of four cases. BMC Cancer 6:117. doi:10.1186/1471-2407-6-117 PubMedCentralCrossRefPubMed

20.

Prayer L, Schurawitzki H, Mallek R, Mostbeck G (1992) CT in pancreatic involvement of non-Hodgkin lymphoma. Acta Radiol 33(2):123–127CrossRefPubMed

21.

Salvatore JR, Cooper B, Shah I, Kummet T (2000) Primary pancreatic lymphoma: a case report, literature review, and proposal for nomenclature. Med Oncol 17(3):237–247CrossRefPubMed

22.

Van Beers B, Lalonde L, Soyer P, et al. (1993) Dynamic CT in pancreatic lymphoma. J Comput Assist Tomogr 17(1):94–97CrossRefPubMed

23.

Mergo PJ, Helmberger TK, Buetow PC, Helmberger RC, Ros PR (1997) Pancreatic neoplasms: MR imaging and pathologic correlation. Radiographics 17(2):281–301. doi:10.1148/radiographics.17.2.9084072 CrossRefPubMed

24.

Sandrasegaran K, Lin C, Akisik FM, Tann M (2010) State-of-the-art pancreatic MRI. AJR Am J Roentgenol 195(1):42–53. doi:10.2214/ajr.10.4421 CrossRefPubMed

25.

Schima W, Ba-Ssalamah A, Goetzinger P, Scharitzer M, Koelblinger C (2007) State-of-the-art magnetic resonance imaging of pancreatic cancer. Top Magn Reson Imaging TMRI 18(6):421–429. doi:10.1097/rmr.0b013e31816459e0 CrossRefPubMed

26.

Fujinaga Y, Lall C, Patel A, et al. (2013) MR features of primary and secondary malignant lymphoma of the pancreas: a pictorial review. Insights Imaging 4(3):321–329. doi:10.1007/s13244-013-0242-z PubMedCentralCrossRefPubMed

27.

Ishigami K, Tajima T, Nishie A, et al. (2010) MRI findings of pancreatic lymphoma and autoimmune pancreatitis: a comparative study. Eur J Radiol 74(3):e22–e28. doi:10.1016/j.ejrad.2009.03.022 CrossRefPubMed

28.

Masui T, Katayama M, Kobayashi S, Shimizu S (2005) MR imaging of primary malignant lymphoma of the pancreas. Radiat Med 23(3):213–215PubMed

29.

Lin H, Li SD, Hu XG, Li ZS (2006) Primary pancreatic lymphoma: report of six cases. World J Gastroenterol 12(31):5064–5067PubMedCentralPubMed

30.

Cappell MS, Yao F, Cho KC, Axiotis CA (1989) Lymphoma predominantly involving the pancreas. Dig Dis Sci 34(6):942–947CrossRefPubMed

31.

Pasanen PA, Eskelinen M, Vornanen M, Partanen K (1993) Pancreatic lymphoma. Ann Chir Gynaecol 82(3):207–209PubMed

32.

Abedi SH, Ahmadzadeh A, Nikmanesh A, Mohammad Alizadeh AH (2014) The role of endoscopic ultrasound in primary pancreatic lymphoma presented with acute pancreatitis: a case report. JOP 15(5):493–496PubMed

33.

Carbonetti F, Iannicelli E, Federici M, et al. (2014) Primary pancreatic Burkitt lymphoma presenting as acute pancreatitis. J Gastrointest Cancer 45(Suppl 1):265–269. doi:10.1007/s12029-014-9657-0 CrossRefPubMed

34.

Federico E, Falconi M, Zuodar G, Falconieri G, Puglisi F (2011) B-cell lymphoma presenting as acute pancreatitis. Pancreatology 11(6):553–556. doi:10.1159/000332038 CrossRefPubMed

35.

Furuhashi N, Suzuki K, Sakurai Y, et al. (2014) Differentiation of focal-type autoimmune pancreatitis from pancreatic carcinoma: assessment by multiphase contrast-enhanced CT. Eur Radiol . doi:10.1007/s00330-014-3512-3 PubMed

36.

Takahashi N, Fletcher JG, Fidler JL, et al. (2008) Dual-phase CT of autoimmune pancreatitis: a multireader study. AJR Am J Roentgenol 190(2):280–286. doi:10.2214/ajr.07.2309 CrossRefPubMed

37.

Hur BY, Lee JM, Lee JE, et al. (2012) Magnetic resonance imaging findings of the mass-forming type of autoimmune pancreatitis: comparison with pancreatic adenocarcinoma. J Magn Reson Imaging JMRI 36(1):188–197. doi:10.1002/jmri.23609 CrossRefPubMed

38.

Low G, Panu A, Millo N, Leen E (2011) Multimodality imaging of neoplastic and nonneoplastic solid lesions of the pancreas. Radiographics 31(4):993–1015. doi:10.1148/rg.314105731 CrossRefPubMed

39.

Kwee TC, Kwee RM, Nievelstein RA (2008) Imaging in staging of malignant lymphoma: a systematic review. Blood 111(2):504–516. doi:10.1182/blood-2007-07-101899 CrossRefPubMed

40.

Metser U, Goor O, Lerman H, Naparstek E, Even-Sapir E (2004) PET-CT of extranodal lymphoma. AJR Am J Roentgenol 182(6):1579–1586. doi:10.2214/ajr.182.6.1821579 CrossRefPubMed

41.

Moog F, Bangerter M, Diederichs CG, et al. (1998) Extranodal malignant lymphoma: detection with FDG PET versus CT. Radiology 206(2):475–481. doi:10.1148/radiology.206.2.9457202 CrossRefPubMed

42.

Even-Sapir E, Lievshitz G, Perry C, et al. (2007) Fluorine-18 fluorodeoxyglucose PET/CT patterns of extranodal involvement in patients with non-Hodgkin lymphoma and Hodgkin’s disease. Radiol Clin N Am 45(4):697–709, vii. doi:10.1016/j.rcl.2007.05.009

43.

Ngeow JY, Quek RH, Ng DC, et al. (2009) High SUV uptake on FDG-PET/CT predicts for an aggressive B-cell lymphoma in a prospective study of primary FDG-PET/CT staging in lymphoma. Ann Oncol 20(9):1543–1547. doi:10.1093/annonc/mdp030 CrossRefPubMed

44.

Okada M, Sato N, Ishii K, et al. (2010) FDG PET/CT versus CT, MR imaging, and 67 Ga scintigraphy in the posttherapy evaluation of malignant lymphoma. Radiographics 30(4):939–957. doi:10.1148/rg.304095150 CrossRefPubMed

45.

Paes FM, Kalkanis DG, Sideras PA, Serafini AN (2010) FDG PET/CT of extranodal involvement in non-Hodgkin lymphoma and Hodgkin disease. Radiographics 30(1):269–291. doi:10.1148/rg.301095088 CrossRefPubMed

46.

Dong A, Cui Y, Gao L, et al. (2014) Patterns of FDG uptake in pancreatic non-Hodgkin’s lymphoma lesions. Abdom Imaging 39(1):175–186. doi:10.1007/s00261-013-0041-5 CrossRefPubMed

47.

Dong A, Dong H, Zhang L, Zuo C (2013) Hypermetabolic lesions of the pancreas on FDG PET/CT. Clin Nucl Med 38(9):e354–e366. doi:10.1097/RLU.0b013e3182708503 CrossRefPubMed

48.

Sahani DV, Bonaffini PA, Catalano OA, Guimaraes AR, Blake MA (2012) State-of-the-art PET/CT of the pancreas: current role and emerging indications. Radiographics 32(4):1133–1158 ((discussion 1158–1160)). doi:10.1148/rg.324115143 CrossRefPubMed

49.

Nguyen VX, Nguyen CC, Nguyen BD (2011) (1)(8)F-FDG PET/CT imaging of the pancreas: spectrum of diseases. JOP 12(6):557–566PubMed

50.

Moon SY, Joo KR, So YR, et al. (2013) Predictive value of maximum standardized uptake value (SUVmax) on 18F-FDG PET/CT in patients with locally advanced or metastatic pancreatic cancer. Clin Nucl Med 38(10):778–783. doi:10.1097/RLU.0b013e31829f8c90 CrossRefPubMed

51.

Blastik M, Plavecz E, Zalatnai A (2011) Pancreatic carcinomas in a 60-year, institute-based autopsy material with special emphasis of metastatic pattern. Pancreas 40(3):478–480. doi:10.1097/MPA.0b013e318205e332 CrossRefPubMed

52.

Gagovic V, Spier BJ, DeLee RJ, et al. (2012) Endoscopic ultrasound fine-needle aspiration characteristics of primary adenocarcinoma versus other malignant neoplasms of the pancreas. Can J Gastroenterol = J canadien de gastroenterologie 26(10):691–696

53.

Ramesh J, Hebert-Magee S, Kim H, Trevino J, Varadarajulu S (2014) Frequency of occurrence and characteristics of primary pancreatic lymphoma during endoscopic ultrasound guided fine needle aspiration: a retrospective study. Dig Liver Dis 46(5):470–473. doi:10.1016/j.dld.2013.12.016 PubMedCentralCrossRefPubMed

54.

Puli SR, Bechtold ML, Buxbaum JL, Eloubeidi MA (2013) How good is endoscopic ultrasound-guided fine-needle aspiration in diagnosing the correct etiology for a solid pancreatic mass?: a meta-analysis and systematic review. Pancreas 42(1):20–26. doi:10.1097/MPA.0b013e3182546e79 CrossRefPubMed

55.

Khashab M, Mokadem M, DeWitt J, et al. (2010) Endoscopic ultrasound-guided fine-needle aspiration with or without flow cytometry for the diagnosis of primary pancreatic lymphoma—a case series. Endoscopy 42(3):228–231. doi:10.1055/s-0029-1243859 CrossRefPubMed

56.

Bouvet M, Staerkel GA, Spitz FR, et al. (1998) Primary pancreatic lymphoma. Surgery 123(4):382–390CrossRefPubMed

57.

Webb TH, Lillemoe KD, Pitt HA, Jones RJ, Cameron JL (1989) Pancreatic lymphoma. Is surgery mandatory for diagnosis or treatment? Ann Surg 209(1):25–30PubMedCentralCrossRefPubMed

58.

Saif MW (2006) Primary pancreatic lymphomas. JOP 7(3):262–273PubMed

Medicine Matters Oncology

Abstract

Objective

Conclusion