Clinical Journal of Gastroenterology

, Volume 7, Issue 2, pp 180–184 | Cite as

A case of primary pancreatic lymphoblastic lymphoma diagnosed by endoscopic ultrasound-guided fine-needle aspiration

  • So Nakaji
  • Nobuto Hirata
  • Toshiyasu Shiratori
  • Masayoshi Kobayashi
  • Hiroyuki Fujii
  • Eiji Ishii
  • Kosei Matsue
  • Kazuei Hoshi
Case Report
  • 139 Downloads

Abstract

Pancreatic involvement is an extremely rare manifestation of lymphoblastic lymphoma (LBL), and only a few cases have been reported. We report a case of LBL arising from the pancreas that was diagnosed using endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). The patient was a 57-year-old female who had suffered from abdominal pain for 2 weeks. A physical examination revealed an upper abdominal mass, but did not detect peripheral lymphadenopathy. Imaging studies including computed tomography (CT) and 18F-fluorodeoxy glucose (FDG)-positron emission tomography-CT revealed an enlarged pancreatic body, which was positive for FDG uptake. EUS-FNA detected medium-sized proliferating atypical lymphocytes, and immunohistochemical staining demonstrated that these cells were positive for CD20, CD10, PAX5, and terminal deoxynucleotidyl transferase. A bone marrow examination was negative for lymphoma infiltration, and a diagnosis of LBL arising from the pancreas was made. The patient was successfully treated with a combination of chemotherapy and pancreatic irradiation.

Keywords

Primary pancreatic lymphoma Lymphoblastic lymphoma EUS-FNA 

References

  1. 1.
    Saif MW. Primary pancreatic lymphomas. JOP. 2006;7:262–73.PubMedGoogle Scholar
  2. 2.
    Mishra MV, Keith SW, Shen X, Bar Ad V, Champ CE, Biswas T. Primary pancreatic lymphoma: a population-based analysis using the SEER program. Am J Clin Oncol. 2013;36:38–43.PubMedCrossRefGoogle Scholar
  3. 3.
    Daniel SV, Vani DH, Smith AM, Hill QA, Menon KV. Obstructive jaundice due to a pancreatic mass: a rare presentation of acute lymphoblastic leukaemia in an adult. JOP. 2010;11:72–4.PubMedGoogle Scholar
  4. 4.
    Yasuda I, Goto N, Tsurumi H, Nakashima M, Doi S, Iwashita T, et al. Endoscopic ultrasound-guided fine needle aspiration biopsy for diagnosis of lymphoproliferative disorders: feasibility of immunohistological, flow cytometric, and cytogenetic assessments. Am J Gastroenterol. 2012;107:397–404.PubMedCrossRefGoogle Scholar
  5. 5.
    Behrns KE, Sarr MG, Strckler JG. Pancreatic lymphoma: is it a surgical disease? Pancreas. 1994;9:662–7.PubMedCrossRefGoogle Scholar
  6. 6.
    Merkle EM, Bender GN, Brambs HJ. Imaging finding in pancreatic lymphoma: differential aspects. Am J Roentgenol. 2000;174:671–5.CrossRefGoogle Scholar
  7. 7.
    Kotake F, Uno R, Takahashi Y. Computed tomography findings and diffusion-weighted magnetic resonance imaging of malignant lymphoma located mainly in the pancreas. J Tokyo Med Univ. 2009;67:43–51.Google Scholar
  8. 8.
    Nakaji S, Hirata N, Yoshimura S, Shiratori T, Kobayashi M, Ishii E. A case of primary pancreatic Burkitt’s lymphoma diagnosed by EUS-guided FNA. Gastrointest Endosc. 2013;77:958–9.PubMedCrossRefGoogle Scholar
  9. 9.
    Yasuda I, Turumi H, Omar S, Iwashita T, Kojima Y, Yamada T, et al. Endoscopic ultrasound-guided fine-needle aspiration biopsy for lymphadenopathy of unknown origin. Endoscopy. 2006;38:919–24.PubMedCrossRefGoogle Scholar
  10. 10.
    Nakahara O, Yamao K, Bhatia V, Sawaki A, Mizuno N, Takagi T, et al. Usefulness of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for undiagnosed intra-abdominal lymphadenopathy. J Gastroenterol. 2009;44:562–7.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Japan 2014

Authors and Affiliations

  • So Nakaji
    • 1
  • Nobuto Hirata
    • 1
  • Toshiyasu Shiratori
    • 1
  • Masayoshi Kobayashi
    • 1
  • Hiroyuki Fujii
    • 1
  • Eiji Ishii
    • 1
  • Kosei Matsue
    • 2
  • Kazuei Hoshi
    • 3
  1. 1.Department of GastroenterologyKameda Medical CenterKamogawaJapan
  2. 2.Department of Hematology and OncologyKameda Medical CenterKamogawaJapan
  3. 3.Department of Anatomic PathologyKameda Medical CenterKamogawaJapan

Personalised recommendations