A case of primary pancreatic lymphoma followed in remision in the 9th year

Öz

Primary pancreatic lymphoma (PPL) is a rare form of ekstranodal, lymphomas, comprising 0.2-4.9% of pancreatic masses and <1% of all malignant lymphomas. Due to the rarity of PPL and nonspecific clinical symptoms and imaging, differentiation of PPL from adenocarcinoma is difficult without histopathologic diagnosis. Many patients with primary pancreatic lymphoma are diagnosed after radical surgery due to difficulties in diagnosis. Many patients with primary pancreatic lymphoma can be diagnosed after radical surgical treatments due to diagnostic difficulties. A 70-year-old patient presenting with abdominal pain was detected to have pancreatic mass. The post-operative pathologic outcome was reported as T-rich B-cell lymphoma. The patient was followed with complete remission after receiving six cycles of chemotherapy. This case report emphasizes the importance of distinguishing between pancreatic lymphoma and adenocarcinoma because of the different treatment strategies and prognoses.

Anahtar Kelimeler

• Lymphoma,Pancreas,Mass

Dokuzuncu yılında remisyonda izlenen primer pankreatik lenfoma tanılı bir olgu

Öz

Primer pankreatik lenfoma ekstranodal lenfomaların nadir bir formudur. Tüm pankreatik neoplazmların %0.2-4.9’unu,tüm malign lenfomaların ise %1’den azını oluşturur. Pankreatik lenfomaların nadir olarak görülmesi, spesifik olmayan klinik semptomları ve görüntüleme bulgularının özgüllüğünün az olması nedeniyle histolojik tanı olmaksızın pankreatik adenokarsinomadan ayrımı zordur. Tanısal açıdan yaşanan zorluklar nedeniyle primer pankreatik lenfomalı bir çok hastanın tanıları radikal cerrahi tedaviler sonrasında yapılabilmektedir. Epigastrik ağrı şikayeti ile polikliniğimize başvuran 70 yaşında kadın bir hastada pankreas başında kitle tespit edildi. Opere edilen hastanın postoperatif patoloji sonucu diffüz büyük B hücreli lenfoma olarak raporlandı. Hastaya kemoterapi verildi ve tam remisyon elde edildi.Bu vaka sunumu, tedavi stratejileri ve prognozları farklı olduğu için pankreatik lenfoma ve adenokarsinomun ayrımının önemini vurgular.

Anahtar Kelimeler

• Lenfoma,Pankreas,Kitle

Kaynakça

1. 1.Bouvet M,Staerkel GA,Spitz FR,Curley SA,Charnsangavej C.Primary pancreatic lymphoma.Surgery 123:382-390,1998.2.Salvatore JR,Cooper B,Shah I,Kummet T.Primary pancreatic lymphoma:a case report,literature review and proposal for nomenclature.Med Oncol 2000;17:237-247.3.Zucca E,Roggero E,Bertoni F,Cavalli F.Primary extranodal non-Hodgkin’s lymphomas;Gastrointestinal,cutaneous and genitourinary lymphomas.Ann Oncol 1997;8:727-37.4.Lin H,Li SD,Hu XG,Li ZS.Primary pancreatic lymphoma:Report of six cases.World J Gastroenterol 2006;12:5064-7.5.Cubilla AL,Fitzgerald PJ.Atlas of tumor pathology.2nd ed. p.109-183.Washington DC,Armed Forces Institute of Pathology,1984.6. Basu A, Patil N, Mohindra P, Zade B, Gujral S, Muckaden MA, Laskar S.Isolated non-Hodgkin's lymphoma of the pancreas: case report and review of literature.J Cancer Res Ther. 2007 Oct-Dec;3(4):236-9.7.Dawson IM,Cornes JS,Morson BC.Primary malignant lymphoid tumours of the intestinal tract:Report of 37 cases with a study of factors influencing prognosis.Br J Surg 1961;4:80-91.8. Rad N, Khafaf A, Mohammad Alizadeh AH.Primary pancreatic lymphoma: what we need to know.J Gastrointest Oncol. 2017 Aug;8(4):749-757. doi: 10.21037/jgo.2017.06.03.9.Merkle EM,Bender GN,Brambs HJ.Imaging findings in pancreatic lymphomas:Differential aspects.AJR Am J Roentgenol 2000;174:671-5.10.Shahar KH,Carpenter LS,Jorgensen J et al.Role of radiation therapy in a patient with primary pancreatic lymphoma.Clin Lymphoma Myeloma.2005;6:143-5.11.Webb TH,Lillemoe KD,Pitt HA,Jones RJ et al.Pancreatic lymphoma:is surgery mandatory for diagnosis or treatment? Ann Surg 209:25-30.1989.