Primary Non-Hodgkin's Lymphoma of the Pancreas: How CanWe Differentiate it from Pancreatic Adenocarcinomas?

Abstract

Background: Primary pancreatic lymphoma (PPL) is a rare condition and its differentiation from most commonly adenocarcinoma is very important because of different prognosis and treatment strategies. The aim of this study was presenting different aspects for differentiating PPL from pancreatic adenocarcinoma.

Materials andMethods: During 14 months, 5 patients who underwent endoscopic ultrasonography in our ward were recorded. Demographic characteristics, laboratory and imaging findings were evaluated. Literature review was done.

Results: The duration of symptoms was between one to two months. The primary presenting symptoms were abdominal pain, weight loss, jaundice and pruritus. All patient except one, diagnosed as primary pancreatic lymphoma by EUS-guided fine-needle aspiration. Occasional presence of B-symptoms, larger size of the lesion, less occurrence of invasion to the large vessels despite larger size, less occurrence of obstructive jaundice (in spite of greater frequency in the head of the pancreas) and normal or lower titer of CA19-9 may be useful keys for differentiating primary pancreatic lymphoma from pancreatic cancer.

Conclusion: Although cytology or tissue histology is fundamental for the diagnosis, clinical, laboratory and imaging findings may be valuable tools for differentiation PPL from pancreatic adenocarcinoma.