title: Frequency of occurrence and characteristics of primary pancreatic lymphoma during endoscopic ultrasound guided fine needle aspiration: a retrospective study.
abstract: BACKGROUND
  Primary pancreatic lymphoma is a rare tumour of the pancreas. Data on the role of endoscopic ultrasound guided fine needle aspiration for its diagnosis are scant.
  
  
  OBJECTIVE
  To identify the frequency of occurrence, sonographic characteristics and cytological findings that are predictive of primary pancreatic lymphoma.
  
  
  METHODS
  Pancreatic lymphoma cases were identified by retrospective review of solid pancreatic masses over 10-year period.
  
  
  RESULTS
  12/2397 (0.5%) lesions were identified. Patients were predominantly white (92%) and male (58%). Mean largest dimension was 47.5mm and 83.3% were located in the head. The mass appeared heterogeneous in 75% and peripancreatic lymphadenopathy was noted in 58%. None of the patients showed features of chronic pancreatitis or pancreatic ductal dilation. Rapid onsite analysis revealed atypical lymphocytes in 92%. Flow cytometry confirmed diagnosis in 75% of cases.
  
  
  CONCLUSIONS
  Primary pancreatic lymphoma is encountered in 0.5% of patients undergoing endoscopic ultrasound guided fine needle aspiration. A large heterogeneous mass, in the absence of chronic pancreatitis or pancreatic duct dilation that reveals atypical lymphocytes on fine needle aspiration is suggestive.
authors.affiliation: Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: j1ramesh@gmail.com.
authors.forename: Jayapal
authors.initials: J
authors.lastname: Ramesh
authors.affiliation: Center for Interventional Endoscopy, Florida Hospital, Orlando, FL, USA; Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Shantel
authors.initials: S
authors.lastname: Hebert-Magee
authors.affiliation: Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Hwasoon
authors.initials: H
authors.lastname: Kim
authors.affiliation: Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Trevino
authors.affiliation: Center for Interventional Endoscopy, Florida Hospital, Orlando, FL, USA.
authors.forename: Shyam
authors.initials: S
authors.lastname: Varadarajulu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001808:Blood Vessels / Q000473:pathology; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000473:pathology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000473:pathology*; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010179:Pancreas / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000473:pathology*; D012189:Retrospective Studies
keywords: EUS; EUS-FNA; Flow cytometry; Primary pancreatic lymphoma