A Man with Pancreatic Head Mass Lesion on Endoscopic Ultrasound and Granuloma on Cytopathology

• Published in: Case reports in gastroenterology 2016-12, Vol.10 (3), p.760-768
• Main Authors: Rad, Neda, Heidarnezhad, Arash, Soheili, Setareh, Mohammad-Alizadeh, Amir Houshang, Nikmanesh, Arash
• Format: Article
• Language: English
• Subjects: Computed tomography-guided core needle biopsy; Endoscopic ultrasound; Endoscopic ultrasound-guided fine needle aspiration; Primary pancreatic lymphoma; Single Case
• ISSN: 1662-0631; 1662-0631
• DOI: 10.1159/000448875

Primary pancreatic lymphoma is an unlikely malignancy accounting for less than 0.5% of pancreatic tumors. Clinical presentation is often nonspecific and may be clinically misdiagnosed as pancreatic adenocarcinoma. Here we present an Iranian case of primary pancreatic lymphoma in a 47-year-old male suffering from jaundice and 20% weight loss. Endoscopic ultrasound revealed a mixed echoic mass lesion at the head of pancreas. The patient underwent endoscopic ultrasound-guided fine needle aspiration of solid pancreatic mass and histopathologic diagnosis revealed granuloma. Computed tomography-guided core needle biopsy was performed and eventually histological examination showed granuloma that was coherent with the diagnosis of primary pancreatic lymphoma. Primary pancreatic lymphoma is a rare entity presenting with nonspecific symptoms, laboratory and radiological findings. Computed tomography results in combination with clinical and radiological studies generally provide guidance for appropriate investigation.