CHARACTERIZATION OF PRIMARY PANCREATIC LYMPHOMA BY EUS FINE NEEDLE ASPIRATION/ BIOPSY: A RETROSPECTIVE STUDY

Aims Primary pancreatic lymphoma is a rare group of malignancies consisting of less than 0.5% of pancreatic cancers and 0.1% of malignant lymphomas. We describe our retrospective experience of characterization of such a rare malignancy by endoscopic ultrasound FNA/B.

Methods Between December 2008 and September 2021, 375 patients with pancreatic mass underwent EUS FNA/B. Samples were analyzed by pathologists experienced in pancreatic neoplasia. We selected patients with final diagnosis of pancreatic lymphoma and then we retrospectively analyzed demographic information, clinical reason of referral, pancreatic site, size, ultrasound appearance, cytological and histological data.

Results 6 of 375 (1.6%) patients were diagnosed with primary pancreatic lymphoma. After preliminary CT scan examination, 5 out of 6 patients were referred to EUS FNA/B with first suspicion of adenocarcinoma. The median age was 65.6 years with slightly male predominance (66,6%). The most frequent site was pancreatic head (83%) with median size of 45.6 mm. Lymphoma was described as hypoechoic solid mass in 90% of cases. Histology and immunochemistry confirmed respectively in 66% and 33% of patients low-grade and high-grade B cell Non-Hodgkin’s Lymphoma. Only two patients showed peri-pancreatic lymph-nodal involvement.

Conclusions Primary pancreatic lymphoma is a challenging diagnosis for poor specificity of symptoms and imaging appearance with risk of misdiagnosis. EUS FNA / B is mandatory for histological confirmation of diagnosis and to ensure the best timely treatment, based on the combination of radio and chemotherapy rather than surgery.

Publication History

Article published online:
14 April 2022