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
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
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.
Keywordsabdominal pain, žltačka, difúzny veľkobunkový B-lymfóm
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