Gastroenterologie
a hepatologie

Primary lymphoma of the pancreas – a case report

Zuzana Vrablicová¹, Iveta Čierna², Daniela Staníková², Alexandra Kolenová³, Andrea Hrašková³, Lukáš Plank⁴, Igor Šturdík¹, Tomáš Koller ^{Orcid.org  1}

+ Affiliation
¹ Gastroenterologické a hepatologické oddelenie, V. interná klinika LF UK a UN Bratislava
² Detská klinika LF UK a NÚDCH, Bratislava
³ Klinika detskej hematológie a onkológie NÚDCH, Bratislava
⁴ Ústav patologickej anatómie, JLF UK a UN Martin

Summary

Abdominal pain is a relatively common symptom in adolescents. The causes that contribute to abdominal pain are varied and the differential dia­gnosis is therefore rather extensive and complex. This is probably related to the fact that the abdomen extends over a relatively large area containing numerous organs, structures, and systems, including the lymph nodes which respond to infection or cancer in a generalized way. In our case report we present the case of a 17-year-old patient with sudden abdominal pain, weight loss, vomiting and jaundice. Laboratory and imaging examinations were performed, focusing on the pancreas and the hepatobiliary tract and showing an enlarged head and tail of the pancreas, peripancreatic lymphadenopathy with a secondary finding of small lesions on the kidneys. Firstly, we suspected hereditary pancreatitis and pseudotumors in the kidney, while pancreatic tumor and metastases were considered less likely, given the patient’s age. The definitive dia­gnosis was established by collecting bio­psy samples from the pancreas via endosonographic examination. Histological and cytological findings showed the presence of lymphocyte blast cells of the CD20 + B-NHL nature, dia­gnosed as diffuse large B cell lymphoma (DLBCL). Staging of the disease showed no infiltration of malignant cells in the bone marrow and central nervous system. The prompt dia­gnosis and administration of appropriate oncological treatment (chemotherapy in combination with a monoclonal antibody) ensured the patient’s return to daily life and they were a necessary prerequisite for a favorable prognosis of the patient.

Keywords

abdominal pain, žltačka, difúzny veľkobunkový B-lymfóm

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