title: Primary pancreatic Burkitt's lymphoma mimicking carcinoma with obstructive jaundice and very high CA19-9.
abstract: 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.
authors.affiliation: Department of Radiology, Cathay General Hospital, 18 Hsinhai Road, Pan Chiao City, Taipei Hsien 220, Taiwan, ROC. ab0506@ms35.hinet.net
authors.forename: Yu Jen
authors.initials: YJ
authors.lastname: Wang
authors.forename: Chin Ming
authors.initials: CM
authors.lastname: Jeng
authors.forename: Young Chen
authors.initials: YC
authors.lastname: Wang
authors.forename: Pi Peng
authors.initials: PP
authors.lastname: Chang
authors.forename: Tsung His
authors.initials: TH
authors.lastname: Wang
mesh_terms: 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
chemical_list: D018395:CA-19-9 Antigen