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Is Pancreatic Mass always Adenocarcinoma? | OMICS International
ISSN: 2165-7920
Journal of Clinical Case Reports
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Is Pancreatic Mass always Adenocarcinoma?

Faisal Musa*, Fahd Mousi, Lohini Sundharkrishnan and Daniel Landau
UF Cancer Center at Orlando Health, Orlando, Florida, USA
Corresponding Author : Faisal Musa
UF Cancer Center at Orlando Health
Orlando, Florida
Tel: 407-648-3800
E-mail: [email protected]
Received April 18, 2015; Accepted April 22, 2015; Published April 24, 2015
Citation: Musa F, Mousi F, Sundharkrishnan L, Landau D (2015) Is Pancreatic Mass always Adenocarcinoma? J Clin Case Rep 5:i110. doi:10.4172/2165-7920.1000i110
Copyright: © 2015 Musa F, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

57-year-old man with past medical history of diabetes, hypertension and depression who was evaluated for obstructive jaundice, and was found on CT scan of abdomen to have a hypoenhancing 2.6 x 2.1 cm mass within the posterior and medial aspect of the pancreatic head which abutted the common bile duct and superior pancreatic duodenal branch from the common hepatic artery highly suspicious for pancreatic adenocarcinoma.

Clinical Image
57-year-old man with past medical history of diabetes, hypertension and depression who was evaluated for obstructive jaundice, and was found on CT scan of abdomen to have a hypoenhancing 2.6 x 2.1 cm mass within the posterior and medial aspect of the pancreatic head which abutted the common bile duct and superior pancreatic duodenal branch from the common hepatic artery highly suspicious for pancreatic adenocarcinoma (Figures 1 and 2). Initial biopsy was nondiagnostic. A CA19.9 was 1327 U/ML (0-35). He underwent a Whipple procedure however the pathology revealed diffuse large B-cell lymphoma arising in association with a high-grade follicular lymphoma, 3.1 cm in greatest diameter involving the head of the pancreas and duodenal wall with two out of 20 lymph nodes also positive for high-grade follicular lymphoma (Figures 3-6). He was treated with 6 cycles of R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, Prednisone) for stage II disease. He is now two years from therapy and has no evidence of disease.
The incidence of primary pancreatic lymphomaPPL is extremely rare.Fewer than 2% of extranodal malignant lymphomas and 0.5% of all pancreatic masses constitute PPL [1-3]. Up until 2006, fewer than 150 cases of PPL have been reported in the English medical literature [4].
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