Secondary pancreatic involvement by diffuse large B-cell lymphoma presenting as acute pancreatitis: treatment and outcome.
We report the case of a 33-year-old man who presented with a large B-cell non Hodgkin's lymphoma presenting as acute pancreatitis. Abdominal CT showed diffuse swelling of the pancreas, with two distinct masses in the corpus and the tail. Thoracic CT showed a markedly enlarged mediastinum, with a voluminous mass in the middle mediastinum. Direct biopsy of this mass revealed a large B-cell lymphoma. Chemotherapy followed by peripheral blood cell autotransplantation led to complete disappearance of the pancreatic and mediastinal masses. Fatty diarrhea occurred after chemotherapy, probably owing to gland destruction by lymphomatous infiltration. Twenty-six months later, the patient is disease-free but continues to require pancreatic enzyme supplements.
Bernardeau
Marianne
M
Department of Gastroenterology and Hepatology, Henry Mondor University Hospital, Créteil, France.
Auroux
Jean
J
Cavicchi
Maryan
M
Haioun
Corinne
C
Tsakiris
Laurent
L
Delchier
Jean Charles
JC
D000208:Acute Disease; D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D010188:Exocrine Pancreatic Insufficiency / Q000139:chemically induced; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D008297:Male; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D010195:Pancreatitis / Q000000981:diagnostic imaging / Q000209:etiology*; D012074:Remission Induction; D014057:Tomography, X-Ray Computed
D000970:Antineoplastic Agents; D018906:Antineoplastic Agents, Alkylating; D000972:Antineoplastic Agents, Phytogenic; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide