Primary Gastric Lymphoma Presenting as Acute Pancreatitis: A Case Report

  • Mithun Raj Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences. Lucknow, India
  • Uday C Ghoshal Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences. Lucknow, India
  • Gourdas Choudhuri Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences. Lucknow, India
  • Samir Mohindra Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences. Lucknow, India
Keywords: Lymphoma, Non-Hodgkin, Pancreas, Stomach Neoplasms

Abstract

Context Diffuse large B-cell lymphoma is the commonest form of non-Hodgkin lymphoma. Gastro-intestinal tract and bone marrow are common extra-nodal sites of lymphomatous involvement. Case report A 54-year-old woman presented with acute onset epigastric pain. On evaluation, raised serum amylase and radiological features of acute pancreatitis were detected. Gastroscopy revealed thickened folds in distal stomach, which on histopathology revealed large B-cell lymphoma. Subsequently, the patient developed extra-hepatic biliary obstruction due to peripancreatic lymph nodal mass that was relieved with plastic biliary stenting. Subsequent chemotherapy regime directed against lymphoma led to resolution of lymphoma. Conclusion In this patient , pancreatitis was the initial presentation of primary gastric lymphoma, which has not been commonly reported and therefore should be considered in the etiological workup.

Image: Thickened gastric folds in distal body.

Downloads

Download data is not yet available.

Author Biography

Samir Mohindra, Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences. Lucknow, India

Associate  Professor. Department of Gastroenterology. SGPGI, Lucknow, 226014, INDIA

References

Ghai S, Pattison J, Ghai S, O'Malley ME, Khalili K, Stephens M. Primary gastrointestinal lymphoma: spectrum of imaging findings with pathologic correlation. Radiographics 2007; 27:1371-88

Psyrri A, Papageorgiou S, Economopoulos T. Primary extranodal lymphomas of stomach: clinical presentation, diagnostic pitfalls and management. Ann Oncol. 2008; 19:1992-9

Shanbhogue AK, Fasih N, Surabhi VR, Doherty GP, Shanbhogue DK, Sethi SK.. A clinical and radiologic review of uncommon types and causes of pancreatitis. Radiographics. 2009 ;29:1003-26.

Robert H. Collins. Jr. Gastrointestinal Lymphomas. In: Feldman M; Friedman L S; Brandt L J, editors.

Sleisenger & Fordtran's gastrointestinal and liver disease: pathophysiology, diagnosis, management 8. Philadelphia: Saunders; 2006. p 567-85

Miljkovic' M,Senadhi V. Use of endoscopic ultrasound in diagnosing plasmacytoma of the pancreas. JOP. 2012 Jan 10;13(1):26-9.

Fischbach W, Al-Taie O. Staging role of EUS. Best Pract Res ClinGastroenterol. 2010 Feb;24(1):13-7

Gambill EE. Pancreatitis associated with pancreatic carcinoma: a study of 26 cases. Mayo Clin Proc. 1971; 46:174-7.

Lin A, Feller ER. Pancreatic carcinoma as a cause of unexplained pancreatitis: report of ten cases. Ann Intern Med. 1990; 113:166-7.

Saif MW, Khubchandani S, Walczak M. Secondary pancreatic involvement by a diffuse large B-cell lymphoma presenting as acute pancreatitis. World J Gastroenterol 2007;13: 4909-11

Wu CM, Cheng LC, Lo GH, Lai KH, Cheng CL, Pan WC. Malignant lymphoma of spleen presenting as acute pancreatitis: a case report. World J Gastroenterol. 2007; 13:3773-5.

Reddy D, Gumaste V, Benisovich V Primary pancreatic lymphoma presenting as acute pancreatitis. Pancreatology. 2003; 3:403-5.

Yoon WJ, Yoon YB, Kim YJ, Ryu JK, Kim YT. Primary pancreatic lymphoma in Korea--a single center experience. J Korean Med Sci. 2010;25:536-40.

Thickened gastric folds in distal body
Published
2013-07-10
How to Cite
Raj, M., Ghoshal, U., Choudhuri, G., & Mohindra, S. (2013). Primary Gastric Lymphoma Presenting as Acute Pancreatitis: A Case Report. JOP. Journal of the Pancreas, 14(4), 463-465. https://doi.org/10.6092/1590-8577/1186
Section
CASE REPORTS