- Pancreatic Lymphoma: Facts
- May simulate a pancreatic adenocarcinoma but usually more infiltrating, and does not obstruct the pancreatic duct usually
- More common to be secondary involvement by lymphoma than primary involvement
- When primary the pancreas may be the only organ of involvement like this case. When secondary will involve multiple organs and organ systems - Pancreatic Lymphoma: Facts
- Secondary Lymphoma may have;
- Large homogeneous mass
- Peripancreatic adenopathy
- Peripancreatic vessels splayed or stretched but not occluded
- Pancreatic duct dilatation is rare - Pancreatic Involvement by Lymphoma: Findings
- Pancreas is involved in about 30% of cases of NHL
- Patterns include a circumscribed mass, diffuse infiltration with glandular enlargement
- Pancreatic duct dilatation is rare
- Pancreatic Lymphoma
- Primary pancreatic lymphoma is a rare extranodal manifestation of any histopathologic subtype of B-cell non-Hodgkin's lymphoma that predominantly involves the pancreas
- Instead of being primary in the gland, pancreatic lymphoma can also represent direct extension from adjacent peripancreatic lymphadenopathy.
- Merkle AJR 2000; 174:671-675.
- Pancreatic Lymphoma
- Diagnostic criteria of primary pancreatic lymphoma include a pancreatic mass that predominates with gross involvement of only the peripancreatic lymph nodes
- no hepatic or splenic involvement
- no palpable superficial lymphadenopathy
- no enlargement of the mediastinal lymph nodes
- normal leukocyte count
- Pancreatic Lymphoma
- Pancreas is involved secondarily in more than 30% of patients with non-Hodgkin's lymphoma but < 2% of extranodal non-Hodgkin's lymphomas arise in the pancreas
- The incidence increases to 5% in HIV patients because the gastrointestinal tract is the most commonly affected extranodal site in AIDS-related non-Hodgkin's lymphoma
- Pancreatic Lymphoma
- CT Findings
- Focal mass
- Can be easily misinterpreted as adenocarcinoma, especially in patients with ductal dilatation (usually <5mm)
- If enlarged lymph nodes are encountered below the level of the renal veins, virtual exclusion of adenocarcinoma is possible
- Diffuse infiltrating mass replacing most of the pancreatic gland
- May mimic the imaging findings of acute pancreatitis with gland enlargement and irregular infiltration of the peripancreatic fat
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