%0 Journal Article
%T Metastatic Lymph Node Impostor in Pancreatic Cystadenocarcinoma
%A Vu CKF
%A Chang F
%A Doig L
%A Meenan J
%J JOP Journal of the Pancreas
%D 2005
%I E S Burioni Ricerche Bibliografiche
%X CONTEXT: Lymph node involvement in pancreatic cancer is a predictor of poor patient long-term survival. The detection of multiple metastatic peri-pancreatic nodes by EUS-FNA may dissuade the surgeon from undertaking a curative pancreatic resection. CASE REPORT: We report an interesting case of a man with chronic lymphocytic leukemia, who presented with the diagnostic problem of a pancreatic solid-cystic lesion and multiple malignant-looking peri-pancreatic lymphadenopathy on EUS. EUS-FNA yielded chronic lymphocytic leukaemia involvement in the peri-pancreatic lymph nodes and a markedly elevated CEA in the cystic fluid. The absence of adenocarcinoma involvement of the lymph nodes prompted surgery on the pancreatic lesion with a curative intent. Pancreatic mucinous cystadenocarcinoma was diagnosed and a sub-total pancreatectomy was performed with clear resection margins. All 30 resected peri-pancreatic lymph nodes showed chronic lymphocytic leukemia involvement only. CONCLUSIONS: This case illustrates that abnormal lymphadenopathy adjacent to a primary pancreatic lesion may not necessarily be due to the latter. Systemic lymphoproliferative disease, as in this case, can masquerade as metastatic adenocarcinoma lymph nodes on EUS. EUS-FNA is useful in diagnosing lymphoproliferative disease.
%K Aged
%K Biopsy
%K Fine-Needle
%K Cystadenocarcinoma
%K Cystadenocarcinoma
%K Mucinous
%K Cystadenocarcinoma /complications/diagnosis/secondary/surgery
%K Diagnosis
%K Differential
%K Endosonography
%K Humans
%K Leukemia
%K Lymphatic Diseases
%K Leukemia
%K Lymphocytic
%K Chronic /complications/diagnosis/ultrasonography
%K Lymph Nodes /pathology/surgery/ultrasonography
%K Lymphatic Metastasis /diagnosis/pathology/ultrasonography
%K Lymphocytic
%K Chronic
%K Male
%K Pancreas /pathology/surgery/ultrasonography
%K Pancreatectomy
%K P
%U http://www.joplink.net/prev/200503/04.html