胰腺癌(PC)被列为第14位最常见的癌症,也是癌症相关死亡的第7位主要原因。最常见的组织学类型是腺癌,其他类型,如原发性胰腺淋巴瘤(PPL)仍然非常罕见。由于缺乏特异性的临床和影像学特征,PPL的诊断仍然具有挑战性.我们报告了2019年至2023年间在我们的消化内科诊断和管理的4例PPL病例。病例1:一名16岁男性出现腹痛,黄疸,和减肥。成像显示胰腺有一个8厘米长的肿瘤,随后的活检证实伯基特淋巴瘤。尽管化疗,病人死于疾病。病例2:一名92岁女性,无既往病史,表现为腹痛,黄疸,瘙痒,和减肥。影像学显示胰腺肿块很大,活检发现大B细胞淋巴瘤。不幸的是,患者在治疗开始前去世。病例3:一名63岁男性,有吸烟史,表现为腹痛,减肥,和厌食症。影像学和活检证实弥漫性大细胞B表型淋巴瘤。患者在利妥昔单抗治疗后达到完全缓解,环磷酰胺,盐酸多柔比星,长春新碱,和泼尼松(R-CHOP)治疗。案例4:一名67岁的男子患有黄疸,腹痛,通过影像学和细针穿刺(FNA)诊断为弥漫性大细胞B淋巴瘤。患者对R-CHOP治疗反应良好。总之,PPL是一种罕见的肿瘤,没有特定的临床或放射学特征。对临床的全面评估,放射学,生物学和组织学数据对于将其视为鉴别诊断并确保准确及时的管理是必要的。
Pancreatic cancer (PC) is ranked as the 14th most common cancer and the 7th leading cause of cancer-related deaths. The most common histological type is adenocarcinoma, other type such as primary pancreatic lymphoma (PPL) still very rare. Due to the lack of specific clinical and imaging characteristics, the diagnostic of PPL remains challenging. We report 4 cases of PPL diagnosed and managed at our gastroenterology department between 2019 and 2023. Case 1: A 16-year-old male presented with abdominal pain, jaundice, and weight loss. Imaging revealed an 8 cm tumor in the pancreas, subsequent biopsies confirming Burkitt\'s lymphoma. Despite chemotherapy, the patient succumbed to the disease. Case 2: A 92-year-old female with no prior medical history presented with abdominal pain, jaundice, pruritus, and weight loss. Imaging revealed a large pancreatic mass, and biopsies identified large B-cell lymphoma. Unfortunately, the patient passed away before treatment initiation. Case 3: A 63-year-old male with a history of tobacco smoking presented with abdominal pain, weight loss, and anorexia. Imaging and biopsies confirmed diffuse large cell B-phenotype lymphoma. The patient achieved complete remission after rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine, and prednisone (R-CHOP) therapy. Case 4: A 67-year-old man with jaundice, abdominal pain, and weight loss was diagnosed with diffuse large cell B lymphoma through imaging and fine needle aspiration (FNA). The patient responded well to R-CHOP therapy. In conclusion, PPL is an uncommon tumor, with no specific clinical or radiological characteristics. A thorough evaluation of clinical, radiological, biological and histological data is necessary to consider it as a differential diagnosis and ensure accurate and timely management.