J Korean Soc Radiol.  2010 Aug;63(2):167-171.

Primary Pancreatic Lymphoma with Severe Dilatation of Pancreatic Duct: A Case Report

• Heo TW
• Kim JW
• Heo SH
• Shin SS
• Jeong YY
• Kang HK
• Choi YD

Abstract

Primary pancreatic lymphoma is extremely rare and usually consists of a bulky tumor without internal necrosis and severe dilatation of the pancreatic duct. We report the unusual CT and MRI findings of a primary pancreatic lymphoma in a 27-years-old man, associated with severe dilatation of the pancreatic duct, common bile duct, and internal necrosis.

MeSH Terms

Common Bile Duct
Dilatation
Lymphoma
Lymphoma, Non-Hodgkin
Magnetic Resonance Imaging
Necrosis
Pancreatic Ducts
Pancreatic Neoplasms
Tomography, X-Ray Computed

Figure

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  Fig. 1 Primary pancreatic lymphoma in a 27-year-old man. A. Contrast enhanced MDCT shows poorly enhancing mass (arrowheads) of 5 cm in diameter with low internal attenuation (curved arrow) in the pancreas head, with moderate dilatation of the pancreatic duct (arrow) and both intrahepatic bile ducts. B. T1-weighted MR image shows a hypointense homogeneous mass (arrowheads) with an internal hyperintense area (curved arrow) and severe dilatation of the pancreatic duct (arrow). C. T2-weighted MR image demonstrates a hyperintense mass with an internal hyperintense area (curved arrow) and severe dilatation of the pancreatic duct (arrow). D. Gadolinium-enhanced T1-weighted coronal MR image shows a homogeneous enhancing mass (arrowheads) with a non-enhancing area (asterisk) demonstrating severe dilatation of the distal pancreatic duct (curved arrow) and common bile duct (arrow). E. ERCP demonstrates moderate to severe dilatation of the upstream pancreatic duct (arrowhead), both intrahepatic bile ducts, and the common bile duct (arrow).

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  Fig. 2 Photographs of the tumor. A. photograph of the resected specimen shows a well circumscribed whitish mass at the pancreatic head with invasion of the pancreatic duct (arrow) and duodenal wall (arrowhead). B. Photomicrograph shows focal coagulative necrosis (asterisk) with a well circumscribed margin (arrows), which was considered as hemorrhage on a preoperative MRI (H & E, × 20). C. The tumor cells have an immunoreactivity for CD20, which is suggestive of lymphoma (immunostaining, × 200).

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