Primary pancreatic Burkitt's lymphoma mimicking carcinoma with obstructive jaundice and very high CA19-9.
Primary pancreatic lymphoma is a rare neoplasm. We report the case of a 49-year-old man who presented with biliary obstruction due to a neoplasm involving the pancreatic head. Initial computed tomography revealed a suspicious periampullary mass. Consequently, magnetic resonance imaging was performed 16 days later, showing a relatively clearly defined and homogeneous signal mass in the pancreatic head with biliary dilatation on enhanced study. In combination with high tumour marker associated antigen CA19-9 levels (1872 and 2110 U/ml), these findings were highly suggestive of a pancreatic carcinoma. He underwent Whipple's procedure. Examination of the surgical specimen revealed a Burkitt's lymphoma. This case demonstrates that lymphoma can present with features mimicking pancreatic head carcinoma on imaging, clinical and laboratory studies. Neither clinical nor imaging nor laboratory methods indicate correct diagnosis, but a relatively clearly defined and homogeneous mass should prompt the physician to include lymphoma in a differential diagnosis of a pancreatic mass.
Wang
Yu Jen
YJ
Department of Radiology, Cathay General Hospital, 18 Hsinhai Road, Pan Chiao City, Taipei Hsien 220, Taiwan, ROC. ab0506@ms35.hinet.net
Jeng
Chin Ming
CM
Wang
Young Chen
YC
Chang
Pi Peng
PP
Wang
Tsung His
TH
D002051:Burkitt Lymphoma / Q000175:diagnosis* / Q000473:pathology; D018395:CA-19-9 Antigen / Q000032:analysis*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006801:Humans; D041781:Jaundice, Obstructive / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods
D018395:CA-19-9 Antigen