scholarly journals A Man with Pancreatic Head Mass Lesion on Endoscopic Ultrasound and Granuloma on Cytopathology

2016 ◽  
Vol 10 (3) ◽  
pp. 760-768
Author(s):  
Neda Rad ◽  
Arash Heidarnezhad ◽  
Setareh Soheili ◽  
Amir Houshang Mohammad-Alizadeh ◽  
Arash Nikmanesh
Keyword(s):  
Computed Tomography ◽  
Endoscopic Ultrasound ◽  
Pancreatic Head ◽  
Needle Aspiration ◽  
Mass Lesion ◽  
Pancreatic Tumors ◽  
Histopathologic Diagnosis ◽  
Pancreatic Lymphoma ◽  
Radiological Studies ◽  
Primary Pancreatic Lymphoma

Primary pancreatic lymphoma is an unlikely malignancy accounting for less than 0.5% of pancreatic tumors. Clinical presentation is often nonspecific and may be clinically misdiagnosed as pancreatic adenocarcinoma. Here we present an Iranian case of primary pancreatic lymphoma in a 47-year-old male suffering from jaundice and 20% weight loss. Endoscopic ultrasound revealed a mixed echoic mass lesion at the head of pancreas. The patient underwent endoscopic ultrasound-guided fine needle aspiration of solid pancreatic mass and histopathologic diagnosis revealed granuloma. Computed tomography-guided core needle biopsy was performed and eventually histological examination showed granuloma that was coherent with the diagnosis of primary pancreatic lymphoma. Primary pancreatic lymphoma is a rare entity presenting with nonspecific symptoms, laboratory and radiological findings. Computed tomography results in combination with clinical and radiological studies generally provide guidance for appropriate investigation.

scholarly journals Primary pancreatic lymphoma: diagnostic pitfall of an uncommon medical entity mimicking operable pancreatic carcinoma: case report and review of literature

2021 ◽  
Vol 8 (7) ◽  
pp. 2221
Author(s):  
Dinesh Manchikanti ◽  
Manisha Aggarwal ◽  
Janitta Kundaikar ◽  
Shaji Thomas ◽  
Ashish Arsia ◽  
...  
Keyword(s):  
Pancreatic Head ◽  
Needle Aspiration ◽  
Endoscopic Biopsy ◽  
Uncinate Process ◽  
Ductal Adenocarcinoma ◽  
Imaging Features ◽  
Abdomen Ct ◽  
Pancreatic Lymphoma ◽  
Primary Pancreatic Lymphoma ◽  
Head Of Pancreas

Almost all pancreatic neoplasms, including the commonest pancreatic ductal adenocarcinoma (PDAC) are derived from pancreatic epithelial components. Primary pancreatic lymphoma (PPL) is rare, accounting for less than 0.5% of all primary pancreatic tumours and presents a diagnostic and therapeutic challenge owing to their rarity, difficult access, and clinical and imaging features, which can mimic PDAC. A 26-year-old man presented with pain abdomen, jaundice, anorexia and weight loss for two months, along with two episodes of hematemesis and melena. Examination revealed an icteric patient with no palpable abdominal lump. His had a serum bilirubin of 13.6 mg/dl. His ultrasound abdomen, CT scan and MRCP showed a mass in the head and uncinate process of the pancreas with circumferential nodular thickening in second part of duodenum. Side viewing endoscopy was suggestive of carcinoma head of pancreas with duodenal infiltration, for which endoscopic biopsy was taken which revealed non-Hodgkin's lymphoma B cell type. A PET CT showed a metabolically active mass lesion in the head of pancreas, with no other focus of disease anywhere else, suggestive of primary pancreatic lymphoma. This patient was referred to Medical oncology and started on chemotherapy. Lymphoma should be considered when a large, homogeneous, hypoenhancing mass is encountered in the pancreatic head, and with bulky lymphadenopathy. Preoperative tissue diagnosis such as fine needle aspiration cytology with or without flow cytometry and/or laparoscopy/endoscopy guided tissue biopsy may be necessary. It is crucial to differentiate PPL from pancreatic adenocarcinoma since their treatment is primarily medical and prognosis differs considerably.

Endoscopic Ultrasound-Guided Fine-Needle Aspiration With Liquid-Based Cytologic Preparation in the Diagnosis of Primary Pancreatic Lymphoma

Pancreas ◽  
2010 ◽  
Vol 39 (8) ◽  
pp. 1299-1302 ◽  
Author(s):  
Esther Diana Rossi ◽  
Alberto Larghi ◽  
Elizabeth C. Verna ◽  
Maurizio Martini ◽  
Domenico Galasso ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
Pancreatic Lymphoma ◽  
Primary Pancreatic Lymphoma

scholarly journals Improvement of the Diagnosis of Isoattenuating Pancreatic Carcinomas by Defining their Characteristics on Contrast Enhanced Computed Tomography and Endosonography with Fine-Needle Aspiration (EUS-FNA)

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 776
Author(s):  
Robert Psar ◽  
Ondrej Urban ◽  
Marie Cerna ◽  
Tomas Rohan ◽  
Martin Hill
Keyword(s):  
Computed Tomography ◽  
Pancreatic Cancer ◽  
Pancreatic Duct ◽  
Fine Needle Aspiration ◽  
Pancreatic Head ◽  
Needle Aspiration ◽  
Characteristic Analysis ◽  
Fine Needle ◽  
Contrast Enhanced ◽  
Secondary Signs

(1) Background. The aim was to define typical features of isoattenuating pancreatic carcinomas on computed tomography (CT) and endosonography and determine the yield of fine-needle aspiration endosonography (EUS-FNA) in their diagnosis. (2) Methods. One hundred and seventy-three patients with pancreatic carcinomas underwent multiphase contrast-enhanced CT followed by EUS-FNA at the time of diagnosis. Secondary signs on CT, size and location on EUS, and the yield of EUS-FNA in isoattenuating and hypoattenuating pancreatic cancer, were evaluated. (3) Results. Isoattenuating pancreatic carcinomas occurred in 12.1% of patients. Secondary signs of isoattenuating pancreatic carcinomas on CT were present in 95.2% cases and included dilatation of the pancreatic duct and/or the common bile duct (85.7%), interruption of the pancreatic duct (76.2%), abnormal pancreatic contour (33.3%), and atrophy of the distal parenchyma (9.5%) Compared to hypoattenuating pancreatic carcinomas, isoattenuating carcinomas were more often localized in the pancreatic head (100% vs. 59.2%; p < 0.001). In ROC (receiver operating characteristic) analysis, the optimal cut-off value for the size of isoattenuating carcinomas on EUS was ≤ 25 mm (AUC = 0.898). The sensitivity of EUS-FNA in confirmation of isoattenuating and hypoattenuating pancreatic cancer were 90.5% and 92.8% (p = 0.886). (4) Conclusions. Isoattenuating pancreatic head carcinoma can be revealed by indirect signs on CT and confirmed with high sensitivity by EUS-FNA.

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