%0 Journal Article
%T Primary pancreatic lymphoma ¨C pancreatic tumours that are potentially curable without resection, a retrospective review of four cases
%A Peter S Grimison
%A Melvin T Chin
%A Michelle L Harrison
%A David Goldstein
%J BMC Cancer
%D 2006
%I BioMed Central
%R 10.1186/1471-2407-6-117
%X Four cases of primary pancreatic lymphoma were identified at Prince of Wales Hospital, Sydney, Australia. A literature review of cases of PPL reported between 1985 and 2005 was conducted, and outcomes were contrasted.All four patients presented with upper abdominal symptoms associated with weight loss. One case was diagnosed without surgery. No patients underwent pancreatectomy. All patients were treated with chemotherapy and radiotherapy, and two of four patients received rituximab. One patient died at 32 months. Three patients are disease free at 15, 25 and 64 months, one after successful retreatment. Literature review identified a further 103 patients in 11 case series. Outcomes in our series and other series of chemotherapy and radiotherapy compared favourably to surgical series.Biopsy of all pancreatic masses is essential, to exclude potentially curable conditions such as PPL, and can be performed without laparotomy. Combined multimodality treatment, utilising chemotherapy and radiotherapy, without surgical resection is advocated but a cooperative prospective study would lead to further improvement in treatment outcomes.Primary pancreatic lymphoma (PPL) is rare, comprising less than 0.5% of pancreatic tumours[1]. To distinguish PPL from secondary involvement of the pancreas by non-Hodgkin's lymphoma, Behrns' clinical and diagnostic criteria of PPL include: mass predominantly within the pancreas with grossly involved lymph nodes confined to the peripancreatic region, no palpable superficial lymphadenopathy, no hepatic or splenic involvement, no mediastinal nodal enlargement on chest radiograph, and normal white cell count [2]. Presenting symptoms are non-specific, typically including abdominal pain, weight loss, nausea and vomiting [2]; but also jaundice, acute pancreatitis, and small bowel obstruction [3]. PPL can be difficult to differentiate from pancreatic adenocarcinoma without definitive pathological diagnosis[3], and correct diagnosis is crucial given tha
%U http://www.biomedcentral.com/1471-2407/6/117