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[Primary pancreatic lymphoma with elevated serum CA19-9 level].
Keiki Kawakami1, Hideki Nomura, Yasuyuki Watanabe
1Division of Hematology, JA Suzuka Hospital.
Summary
Primary pancreatic lymphoma can mimic pancreatic cancer on imaging. Early consideration of lymphoma is crucial for patients with atypical findings, preventing misdiagnosis and improving patient outcomes.
Area of Science:
- Gastroenterology
- Oncology
- Radiology
Background:
- Primary pancreatic lymphoma is a rare malignancy.
- Pancreatic adenocarcinoma is the most common malignancy in the pancreas.
Observation:
- A 71-year-old male presented with upper abdominal pain and elevated CA 19-9 levels.
- Imaging studies (CT, angiography, ERCP) suggested pancreatic head adenocarcinoma.
- Intraoperative lymph node biopsy revealed lymphoplasmacytic lymphoma.
Findings:
- Postoperative complications, including leakage and sepsis, led to patient mortality.
- Retrospective analysis indicated that CT findings of a well-defined, homogeneous low-density mass were more suggestive of lymphoma than adenocarcinoma.
Implications:
- This case highlights the importance of considering pancreatic lymphoma in the differential diagnosis of pancreatic head masses, especially when imaging findings are atypical.
- Atypical imaging features in suspected pancreatic adenocarcinoma warrant thorough investigation to rule out lymphoma.
- Accurate diagnosis is critical for appropriate treatment and improved patient prognosis.