Pancreatic T/histiocyte-rich large B-cell lymphoma: A case report and review of literature

World J Gastroenterol. 2017 Jun 28;23(24):4467-4472. doi: 10.3748/wjg.v23.i24.4467.

Abstract

Primary pancreatic lymphoma (PPL) is an extremely rare form of extranodal malignant lymphoma. The most common histological subtype of PPL is diffuse large B cell lymphoma (DLBCL). In rare cases, PPL can also present as follicular lymphoma, small lymphocytic lymphoma, and T cell lymphoma either of non-Hodgkin's lymphoma or of Hodgkin's lymphoma. T-cell/histiocyte-rich large B-cell lymphoma (T/HRBCL) is an uncommon morphologic variant of DLBCL with aggressive clinical course, it is predominantly a nodal disease, but extranodal sites such as bone marrow, liver, and spleen can be involved. Pancreatic involvement of T/HRBCL was not presented before. Herein, we report a 48-year-old male who was hospitalized with complaints of jaundice, dark brown urine, pale stools, and nausea. The radiological evaluation revealed a pancreatic head mass and, following operative biopsy, the tumor was diagnosed as T/HRBCL. The patient achieved remission after six cycles of CHOP chemotherapy. Therefore, T/HRBCL can be treated similarly to the stage-matched DLBCL and both of them get equivalent outcomes after chemotherapy.

Keywords: Diagnosis; Immunohistochemistry; Non-Hodgkin’s lymphoma; Primary pancreatic lymphoma; T-cell/histiocyte-rich large B-cell lymphoma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bile Ducts / diagnostic imaging
  • Bile Ducts / surgery
  • Biopsy
  • Chemotherapy, Adjuvant / methods
  • Cholangiopancreatography, Endoscopic Retrograde
  • Choledochostomy
  • Cyclophosphamide / therapeutic use
  • Diagnosis, Differential
  • Doxorubicin / therapeutic use
  • Gastroenterostomy
  • Histiocytes / pathology*
  • Hodgkin Disease / diagnosis
  • Humans
  • Jaundice / etiology
  • Jaundice / surgery
  • Jejunum / surgery
  • Liver Function Tests
  • Lymph Nodes / pathology
  • Lymphatic Metastasis
  • Lymphoma, Large B-Cell, Diffuse / complications
  • Lymphoma, Large B-Cell, Diffuse / diagnosis*
  • Lymphoma, Large B-Cell, Diffuse / pathology
  • Lymphoma, Large B-Cell, Diffuse / therapy*
  • Male
  • Mesentery / pathology
  • Middle Aged
  • Nausea / etiology
  • Nausea / surgery
  • Pancreas / diagnostic imaging
  • Pancreas / pathology
  • Pancreatic Neoplasms / complications
  • Pancreatic Neoplasms / diagnosis*
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / therapy*
  • Pancreatitis / diagnosis
  • Prednisone / therapeutic use
  • Stomach / surgery
  • Tomography, X-Ray Computed
  • Vincristine / therapeutic use

Substances

  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone

Supplementary concepts

  • CHOP protocol