J Korean Med Sci.  2010 Apr;25(4):536-540. 10.3346/jkms.2010.25.4.536.

Primary Pancreatic Lymphoma in Korea-A Single Center Experience

Affiliations
  • 1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. yyb10604@plaza.snu.ac.kr

Abstract

The aim of this study was to report a single center experience of primary pancreatic lymphoma (PPL) in Korea. We analyzed the clinicopathological data from four PPL patients (three male, median age 36 yr) diagnosed from 1997 to 2007 at Seoul National University Hospital. The diagnoses were: diffuse large B cell lymphoma (n=2), Ki-1 (+) anaplastic large cell lymphoma (n=1), and Burkitt lymphoma (n=1). Presenting symptoms and signs were: abdominal pain (n=4), pancreatitis (n=2), weight loss (n=2) and abdominal mass (n=1). No patient underwent surgery. The Ann Arbor stages of the patients were: IEA (n=1), IIEA (n=1), and IVEB (n=2). Two patients underwent treatment. The stage IEA patient underwent chemotherapy and radiation therapy that resulted in a complete remission. The stage IVEB patient who underwent chemotherapy relapsed. This patient underwent subsequent peripheral blood stem cell transplantation and is alive at 30 months. Two patients (stages IVEB and IIEA) without treatment died at 0.8 and 7.0 months, respectively. For PPL patients, chemotherapy-based treatment, and addition of radiation therapy, if possible, may offer good prognosis.

Keyword

Pancreas; Lymphoma

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Child
Female
Humans
Korea
Lymphoma/classification/diagnosis/*pathology/therapy
Male
Middle Aged
Pancreatic Neoplasms/classification/diagnosis/*pathology/therapy
Prognosis
Retrospective Studies
Treatment Outcome
Young Adult

Figure

  • Fig. 1 Pathology findings of case 4. (A) Photomicrograph shows starry sky appearance and small non-cleaved cells (H&E, ×400). (B) The specimen shows immunoreactivity for Ki-67 and (C) bcl-6.

  • Fig. 2 CT findings of case 4. Homogenous, hypodense tumorous lesion is replacing almost the entire pancreas. (A) Dilatation of the main pancreatic duct is noted. Multiple nodules are also found in both kidneys. (B) CT taken 1 yr after peripheral blood stem cell transplantation shows disappearance of lesions in the pancreas and kidneys.


Reference

1. Hamilton SR, Lauri LA. Pathology and genetics of tumours of the digestive system. World Health Organization Classification of Tumours. 2000. Lyon: IARC Press.
2. Nayer H, Weir EG, Sheth S, Ali SZ. Primary pancreatic lymphomas: a cytopathologic analysis of a rare malignancy. Cancer. 2004. 102:315–321.
3. 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. 49:80–89.
Article
4. Saif MW. Primary pancreatic lymphomas. JOP. 2006. 7:262–273.
5. Bouvet M, Staerkel GA, Spitz FR, Curley SA, Charnsangavej C, Hagemeister FB, Janjan NA, Pisters PW, Evans DB. Primary pancreatic lymphoma. Surgery. 1998. 123:382–390.
Article
6. Lin H, Li SD, Hu XG, Li ZS. Primary pancreatic lymphoma: report of six cases. World J Gastroenterol. 2006. 12:5064–5067.
Article
7. Ezzat A, Jamshed A, Khafaga Y, Rahal M, Linjawi T, Martin J, Taha I. Primary pancreatic non-Hodgkin's lymphomas. J Clin Gastroenterol. 1996. 23:109–112.
Article
8. Tuchek JM, De Jong SA, Pickleman J. Diagnosis, surgical intervention, and prognosis of primary pancreatic lymphoma. Am Surg. 1993. 59:513–518.
9. Webb TH, Lillemoe KD, Pitt HA, Jones RJ, Cameron JL. Pancreatic lymphoma. Is surgery mandatory for diagnosis or treatment? Ann Surg. 1989. 209:25–30.
Article
10. Behrns KE, Sarr MG, Strickler JG. Pancreatic lymphoma: is it a surgical disease? Pancreas. 1994. 9:662–667.
11. Mansour GM, Cucchiaro G, Niotis MT, Fetter BF, Moore J, Rice RR, Branum GD, Meyers WC. Surgical management of pancreatic lymphoma. Arch Surg. 1989. 124:1287–1289.
Article
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. 60:322–329.
Article
13. Nam SY, Chung JP, Kim E, Lee JH, Kim KW, Jeong HJ, Chung JB, Hahn JS, Kang JK, Park IS. A case of primary T-cell lymphoma of the pancreas. Korean J Gastroenterol. 1994. 26:892–898.
14. Song JH, Chung WJ, Lee JW, Kuon KS, Shin YW, Park JW, Kim JM. Non-Hodgkin's lymphoma of the pancreas presenting with acute pancreatitis as the first manifestation. Korean J Gastroenterol. 1994. 26:758–763.
15. Lee KS, Park KS, Lee SY, Bae IH, Kim SJ, Han GS, Cha SH, Lee OJ. A case of primary pancreatic T-cell lymphoma. J Korean Radiol Soc. 2006. 55:271–274.
Article
16. Lee MK, Jeon SW, Lee YD, Seo HE, Cho CM, Kim SG, Yoon YK. A case of primary pancreatic non-Hodgkin's lymphoma. Korean J Intern Med. 2006. 21:123–126.
Article
17. Hwang JE, Park CH, Cho YC, Kim SK, Kim HS, Choi SK, Rew JS, Lee WS. A case of primary pancreatic lymphoma that manifested with acute pancreatitis and obstructive jaundice. Korean J Gastrointest Endosc. 2009. 38:176–179.
18. Mortenson MM, Katz MH, Tamm EP, Bhutani MS, Wang H, Evans DB, Fleming JB. Current diagnosis and management of unusual pancreatic tumors. Am J Surg. 2008. 196:100–113.
Article
19. Merkle EM, Bender GN, Brambs HJ. Imaging findings in pancreatic lymphoma: differential aspects. AJR Am J Roentgenol. 2000. 174:671–675.
20. Jones WF, Sheikh MY, McClave SA. AIDS-related non-Hodgkin's lymphoma of the pancreas. Am J Gastroenterol. 1997. 92:335–338.
21. Cario E, Runzi M, Metz K, Layer P, Goebell H. Diagnostic dilemma in pancreatic lymphoma. Case report and review. Int J Pancreatol. 1997. 22:67–71.
22. Brown PC, Hart MJ, White TT. Pancreatic lymphoma, diagnosis and management. Int J Pancreatol. 1987. 2:93–99.
23. Coiffier B. Monoclonal antibody as therapy for malignant lymphomas. C R Biol. 2006. 329:241–254.
Article
Full Text Links
  • JKMS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr