CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2009; 30(01): 20-23
DOI: 10.4103/0971-5851.56331
ORIGINAL ARTICLE

Primary pancreatic lymphoma: Report of three cases with review of literature

Altaf Gauhar Haji
Department of Surgical Oncology, Amrita Institute of Medical Sciences and Research Center, Ernakulam, Kerala, India
,
Shekhar Sharma
Department of Surgical Oncology, Amrita Institute of Medical Sciences and Research Center, Ernakulam, Kerala, India
,
K Abdul Majeed
Department of Medical Oncology, Amrita Institute of Medical Sciences and Research Center, Ernakulam, Kerala, India
,
D K Vijaykumar
Department of Surgical Oncology, Amrita Institute of Medical Sciences and Research Center, Ernakulam, Kerala, India
,
K Pavithran
Department of Medical Oncology, Amrita Institute of Medical Sciences and Research Center, Ernakulam, Kerala, India
,
M Dinesh
Department of Radiation Oncology, Amrita Institute of Medical Sciences and Research Center, Ernakulam, Kerala, India
› Author Affiliations

Abstract

Background:Primary pancreatic lymphoma (PPL) is an extremely rare neoplasm, which may be confused with pancreatic adenocarcinoma. So far only about 150 cases of PPL have been reported.Materials and Methods:We present our experience of 3 cases of PPL over a 4-year period.Results:All the patients presented with vague abdominal pain of duration ranging from 1½ months to 3 months. Two patients had diagnosis confirmed histologically by CT-guided core biopsy or Fine needle aspiration procedure. We were able to avoid unnecessary laparotomy in 2 patients using preoperative guided Fine needle aspiration Cytology, although the third patient did undergo a Whipple′s procedure as the diagnosis of PPL was not considered during the initial workup.Conclusions:There is no significant difference noted with regard to patient′s age or duration of symptoms between patients with either pancreatic adenocarcinoma or PPL. The differential diagnosis of PPL includes pancreatic adenocarcinoma and secondary involvement of pancreas from extra-nodal lymphoma. Combination of two things is suggestive of Pancreatic lymphoma: (1) Bulky localized tumor in pancreatic head (2) Absence of significant dilatation of main pancreatic duct strengthens a diagnosis of pancreatic lymphoma over adenocarcinoma. Majority of patients can be managed with chemotherapy with much better prognosis compared to patients with pancreatic adenocarcinoma. Larger series of patients are needed to evaluate whether chemotherapy, eventually followed by involved-field radiation therapy, is the treatment of choice for PPL.



Publication History

Article published online:
19 November 2021

© 2009. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 Zucca E, Roggero E, Bertoni F, Cavalli F. Primary extranodal non-Hodgkin′s lymphomas: Part 1: Gastrointestinal, cutaneous and genitourinary lymphomas. Ann Oncol 1997;8:727-37.
  • 2 Joly I, David A, Payan MJ, Sahel J, Sarles H. A case of primary non-Hodgkin′s lymphoma of the pancreas. Pancreas 1992;7:118-20.
  • 3 Boni L, Benevento A, Dionigi G, Cabrini L, Dionigi R. Primary pancreatic lymphoma. Surg Endosc 2002;16:1107-8.
  • 4 Ezzat A, Jamshed A, Khafaga Y, Rahal M, Linjawi T, Martin J, et al. Primary pancreatic non-Hodgkin′s lymphomas. J Clin Gastroenterol 1996;23:109-12.
  • 5 Baylor SM, Berg JW. Cross-classification and survival characteristics of 5,000 cases of cancer of the pancreas. J Surg Oncol 1973;5:335-8.
  • 6 Saif MW. Primary pancreatic Lymphomas. J Pancreas 2006;7:262-73.
  • 7 Chakravarty U, Vartak S, Chodankar C, Ranadive N. Primary pancreatic lymphoma. Bombay Hosp J 2005;47:2.
  • 8 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;4:80-9.
  • 9 Behrns KE, Sarr MG, Strickler JG. Pancreatic lymphoma: Is it a surgical disease? Pancreas 1994;9:662-7.
  • 10 Nayer H, Weir EG, Sheth S, Ali SZ. Primary pancreatic lymphoma. Cancer 2004;102:315-21.
  • 11 James JA, Milligan DW, Morgan GJ, Crocker J. Familial pancreatic lymphoma. J Clin Pathol 1998;51:80-2.
  • 12 Nishimura R, Takakuwa T, Hoshida Y, Tsujimoto M, Aozasa K. Primary pancreatic lymphoma: Clinicopathological analysis of 19 cases from Japan and review of the literature. Oncology 2001;60:322-9.
  • 13 Arcari A, Anselmi E, Bernuzzi P, Berte R, Lazzaro A, Moroni CF, et al. Primary pancreatic lymphoma: Report of five cases. Haematologica 2005;90:ECR09.
  • 14 Islam S, Callery MP. Primary pancreatic lymphoma: A diagnosis to remember. Surgery 2001;129:380-3.
  • 15 Merkle EM, Bender GN, Brambs HJ. Imaging findings in pancreatic lymphoma: Differential aspects. Am J Roentgenol 2000;174:671-5.
  • 16 Tuchek JM, De Jong SA, Pickleman J. Diagnosis, surgical intervention, and prognosis of primary pancreatic lymphoma. Am Surg 1993;59:513-8.
  • 17 Faulkner JE, Gaba CE, Powers JD, Yam LT. Diagnosis of primary pancreatic lymphoma by fine needle aspiration. Acta Cytol 1998;42:834-6.
  • 18 Kawakami K, Nomura H, Watanabe Y, Momma F. Primary pancreatic lymphoma with elevated serum CA19-9 level. Rinsho Ketsueki 2002;43:292-7.
  • 19 Tondini C, Giardini R, Bozzetti F, Valagussa P, Santoro A, Bertulli R, et al. Combined modality treatment for primary gastrointestinal non-Hodgkin′s lymphoma: The Milan Cancer Institute experience. Ann Oncol 1993;4:831-7.
  • 20 Mansour GM, Cucchiaro G, Niotis MT, Fetter BF, Moore J, Rice RR. Surgical management of pancreatic lymphoma. Arch Surg 1989;124:1287-9.
  • 21 Shahar KH, Carpenter LS, Jorgensen J, Truong L, Baker K, Teh BS. Role of radiation therapy in a patient with primary pancreatic lymphoma. Clin Lymph Myeloma 2005;6:143-5.