title: Primary pancreatic anaplastic large cell lymphoma, ALK negative: a case report.
abstract: We present the fourth case of a primary pancreatic anaplastic large cell lymphoma (ALCL), ALK-. An 80-year-old man was admitted to our clinic for further investigation of a fever of unknown origin. He noted anorexia, weight loss and fatigue. His laboratory tests showed anemia and a great elevation of ESR, LDH, and beta (2) microglobulin. In CT and MRI scan, a soft tissue mass in the pancreas was observed. A repeated endoscopy after his admission revealed an ulcerated mass-like deformity of the duodenal bulb. Explorative laparotomy confirmed a diffuse spread of an unresectable malignant pancreatic mass extending to the adjacent organs. Duodenal and surgical biopsies identified an ALCL of T-cell lineage, ALK-. The patient died in the Intensive Care Unit due to hemodynamic instability. Our case is the first one indicating that primary pancreatic lymphoma should be suspected in a patient with pancreatic mass and elevated serum LDH and beta(2) microglobulin.
authors.affiliation: 1(st) Medical Propedeutic Department, AHEPA Hospital, Aristotle University of Thessaloniki, St. Kyriakidi 1, Thessaloniki 54636, Greece. chrsavop@med.auth.gr
authors.forename: Christos-G
authors.initials: CG
authors.lastname: Savopoulos
authors.forename: N-E
authors.initials: NE
authors.lastname: Tsesmeli
authors.forename: G-D
authors.initials: GD
authors.lastname: Kaiafa
authors.forename: A-T
authors.initials: AT
authors.lastname: Zantidis
authors.forename: M-T
authors.initials: MT
authors.lastname: Bobos
authors.forename: A-I
authors.initials: AI
authors.lastname: Hatzitolios
authors.forename: S-T
authors.initials: ST
authors.lastname: Papavramidis
authors.forename: I-S
authors.initials: IS
authors.lastname: Kostopoulos
mesh_terms: D000369:Aged, 80 and over; D000077548:Anaplastic Lymphoma Kinase; D002277:Carcinoma / Q000378:metabolism / Q000473:pathology; D017809:Fatal Outcome; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000378:metabolism / Q000473:pathology*; D008297:Male; D010190:Pancreatic Neoplasms / Q000378:metabolism / Q000473:pathology*; D011505:Protein-Tyrosine Kinases / Q000378:metabolism*; D020794:Receptor Protein-Tyrosine Kinases
chemical_list: C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D011505:Protein-Tyrosine Kinases; D020794:Receptor Protein-Tyrosine Kinases