Pancreatic Lymphoma Misdiagnosed as Pancreatic Carcinoma (Report of 5 Cases )_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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黃中岳 , 費健 , 王建承 , 陳勝 , 吳衛澤 , 韓天權 , 彭承宏 , 張圣道

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Keywords：

胰腺淋巴瘤; 鑒別診斷; 治療

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目的探討胰腺淋巴瘤和胰腺癌的鑒別診斷及治療。
方法回顧性分析我院2000年1月至2008年4月期間經病理確診的5例胰腺淋巴瘤患者的臨床資料。
結果本組5例患者臨床癥狀以腹痛、發熱、黃疸為主，除1例外血漿CA19-9均正常，臨床表現無法區分胰腺淋巴瘤和胰腺癌，CT等影像學有助于鑒別診斷。胰腺淋巴瘤CT增強掃描后均見強化表現，胰管不粗，和周圍大血管關系緊密，鄰近血管結構被推移，但無浸潤、包繞現象。治療以化療為主，除1例失訪外，其余4例分別存活24、14、14、13個月。
結論胰腺淋巴瘤是一種罕見的疾病，臨床癥狀缺乏特異性，極易與胰腺癌混淆，治療和預后卻與胰腺癌不盡相同，臨床上應該盡量通過CT或超聲下穿刺明確診斷，以避免不必要的手術。

Citation： 黃中岳,費健,王建承,陳勝,吳衛澤,韓天權,彭承宏,張圣道. Pancreatic Lymphoma Misdiagnosed as Pancreatic Carcinoma (Report of 5 Cases ). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(2): 150-151. doi: Copy

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1. Basu A, Patil N, Mohindra P, et al. Isolated non-Hodgkin’s lymphoma of the pancreas: case report and review of literature [Ｊ]. J Cancer Res Ther, 2007; 3(4)： 236.
2. 胡亞，杜瀟，廖泉，等.原發性胰腺淋巴瘤的診療分析 [Ｊ].中國普外基礎與臨床雜志， 2008； 15(4)： 285.
3. Salvatore JR, Cooper B, Shah I, et al. Primary pancreatic lymphoma: a case report, literature review, and proposal for nomenclature [Ｊ]. Med Oncol, 2000; 17(3)： 237.
4. Tuchek JM, De Jong SA, Pickleman J. Diagnosis, surgical intervention and prognosis of primary pancreatic lymphoma [Ｊ]. Am Surg, 1993; 59(8)： 513.
5. Jayanthi V, Randhir J, Rajesh N. Problems in diagnosing lymphoma of the pancreas with computed tomography: A case report [Ｊ]. J Gastrointestin Liver Dis, 2007; 16(1)： 101.
6. Merkle EM, Bender GN, Brambs HJ. Imaging findings in pancreatic lymphoma: differential aspects [Ｊ]. AJR Am J Roentgenol, 2000; 174(3)： 671.
7. Gleeson FC, Zhang L, Levy MJ, et al. Primary pancreatic lymphoma: endoscopic ultrasound-guided Trucut biopsy to the rescue [Ｊ]. Endoscopy, 2008; 40(Suppl 2)： E23.
8. Islam S, Callery MP. Primary pancreatic lymphoma a diagnosis to remember [Ｊ]. Surgery,2001; 129(3)： 380.
9. Lin H, Li SD, Hu XG, et al. Primary pancreatic lymphoma: report of six cases [Ｊ]. World J Gastroenterol， 2006; 12(31)∶5064.
10. 何天霖，胡先貴，劉瑞，等.原發性胰腺淋巴瘤的診斷和治療（附9例報告）[Ｊ]. 第二軍醫大學學報， 2005； 26(8)： 875.
11. Grimison PS, Chin MT, Harrison ML, et al. Primary pancreatic lymphoma-pancreatic tumours that are potentially curable without resection, a retrospective review of four cases [Ｊ]. BMC Cancer, 2006; 6(5)： 117.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Pancreatic Lymphoma Misdiagnosed as Pancreatic Carcinoma (Report of 5 Cases )

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