Case Report
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Sep 28, 2007; 13(36): 4909-4911
Published online Sep 28, 2007. doi: 10.3748/wjg.v13.i36.4909
Secondary pancreatic involvement by a diffuse large B-cell lymphoma presenting as acute pancreatitis
M Wasif Saif, Sapna Khubchandani, Marek Walczak
M Wasif Saif, Yale University School of Medicine, New Haven, CT 06520, United States
Sapna Khubchandani, Marek Walczak, Griffin Hospital, Derby, CT 06520, United States
Author contributions: All authors contributed equally to the work.
Correspondence to: M Wasif Saif, MD, MBBS, Associate Professor, Section of Medical Oncology, Yale University School of Medicine, 333 Cedar Street, FMP: 116, New Haven, CT 06520, United States. wasif.saif@yale.edu
Telephone: +1-203-7371569 Fax: +1-203-7853788
Received: May 3, 2007
Revised: June 1, 2007
Accepted: June 9, 2007
Published online: September 28, 2007
Abstract

Diffuse large B-cell lymphoma is the most common type of non-Hodgkin's lymphoma. More than 50% of patients have some site of extra-nodal involvement at diagnosis, including the gastrointestinal tract and bone marrow. However, a diffuse large B-cell lymphoma presenting as acute pancreatitis is rare. A 57-year-old female presented with abdominal pain and matted lymph nodes in her axilla. She was admitted with a diagnosis of acute pancreatitis. Abdominal computed tomography (CT) scan showed diffusely enlarged pancreas due to infiltrative neoplasm and peripancreatic lymphadenopathy. Biopsy of the axillary mass revealed a large B-cell lymphoma. The patient was classified as stage IV, based on the Ann Arbor Classification, and as having a high-risk lymphoma, based on the International Prognostic Index. She was started on chemotherapy with CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone). Within a week after chemotherapy, the patient’s abdominal pain resolved. Follow-up CT scan of the abdomen revealed a marked decrease in the size of the pancreas and peripancreatic lymphadenopathy. A literature search revealed only seven cases of primary involvement of the pancreas in B-cell lymphoma presenting as acute pancreatitis. However, only one case of secondary pancreatic involvement by B-cell lymphoma presenting as acute pancreatitis has been published. Our case appears to be the second report of such a manifestation. Both cases responded well to chemotherapy.

Keywords: Non-Hodgkin's lymphoma; Acute pancreatitis; Pancreatic lymphoma