Ultrasonography combined with endoscopic ultrasound-guided fine-needle aspiration to diagnosis of primary pancreatic lymphoma: a case report

Abstract

Abstract Background Primary pancreatic lymphoma (PPL) is an extremely rare disease with relatively non-specific clinical symptoms.It is easily overlooked and even misdiagnosed as pancreatic cancer.Clinically, we can rely on ultrasound or CT-guided aspiration for histopathological examination.These can avoid unnecessary dissection procedures and complications and reduce the lethality of lymphoma. Case presentation A 79-year-old woman was admitted to the hospital with "abdominal pain with cough for 1 month and worsening abdominal distension for 2 weeks".Abdominal CT/MRI: irregular soft tissue mass in the caudal region of the pancreatic body, multiple enlarged lymph nodes in the abdominal cavity and retroperitoneum, partially fused in the form of masses, metastasis was considered. Ultrasonography results: pancreatic cancer.Pathology of the abdominal mass puncture was suggestive of aggressive B-cell lymphoma.After pathological confirmation on November 20, 2021, she was transferred to the hematology department for chemotherapy with CHOP, CHOPE, and R-ESHAP regimens.She was stabilized after chemotherapy and then progressed and died in October 2022. Conclusions The diagnosis of PPL requires a multidisciplinary treatment model,full communication and in-depth discussion with all auxiliary and clinical departments to solve difficult problems, improve the level of treatment, promote individualized and standardized treatment of lymphoma, achieve early diagnosis and treatment, and thus reduce the mortality of lymphoma.