Primary Pancreatic Lymphoma, A Case Report and Review of Literature

Background: Primary pancreatic lymphomas (PPL) are extremely rare, comprising less than 0.5% of pancreatic tumors. Usually, primary pancreatic lymphoma appears with symptoms of carcinoma of the pancreatic head. Case Presentation: This case report describes the presentation of primary pancreatic lymphomas. A 74-year-old man has presented history of intermittent abdominal pain associated with intermittent vomiting, anorexia, weight loss and major asthenia. On physical examination we found abdominal distention associated with painful epigastric mass. Abdominal computed tomography (CT) revealed an irregular solid lesion of head and body of the pancreas associated with mesenteric and retroperitoneal lymph nodes, and signs of portal hypertension. The biopsy with immunohistochemical stains of lymph nodes was compatible with diffuse large B-cell lymphoma. The patient was provided to be treated by RCHOP regimen chemotherapy; unfortunately, he died before starting the first cycle. Discussion: Primary pancreatic lymphoma (PPL) is an extremely rare disease that can be revealed as an isolated mass mimicking pancreatic carcinoma. The clinical presentation is not specific, furthermore, signs suggesting lymphomatous involvement are also rare and the diagnosis is based on imaging, and pathologic examination with immunochemical stain. Chemotherapy is the treatment of choice for most patients with pancreatic lymphoma. Conclusion: PPL is a rare clinical entity, histopathologic examination is required for establish diagnosis. Management of patients with PPL is based on chemotherapy treatment and has a much better prognosis than those with adenocarcinoma.