Primary pancreatic non-Hodgkin's lymphomas

Primary pancreatic lymphomas are rare. We reviewed our experience at King Faisal Specialist Hospital and Research Center; the hospital tumor registry identified five patients with primary pancreatic lymphoma among the 1,212 adult non-Hodgkin's (NHL) cases referred to this institute during 1987-1994. The histology was diffuse large cell in all cases. According to the Ann Arbor classification, four patients had stage IE and one patient stage IIE disease. The diagnosis was established by laparotomy in three and ultrasound or CT-guided biopsy in two patients. All patients received chemotherapy. Radiotherapy was used in two cases; in one patient the pancreatic bed was irradiated, whereas in the other radiation was given for obstructive jaundice. Four patients are alive with no evidence of disease at 84, 26, 24, and 21 months follow-up. One patient relapsed at 12 months following chemotherapy and is alive with disease at 23 months follow-up. The clinical and radiological findings in primary pancreatic NHL are not pathognomonic, and the diagnosis is only established on histopathological examination. The management should be nonsurgical as the response to chemotherapy and radiation appears to be no different from NHL at other sites.