Primary pancreatic follicle center-derived lymphoma masquerading as carcinoma.

Address correspondence to: Dr. Jey-Hsin Chen, CellNetix Pathology and Laboratories, 1124 Columbia Street, Suite 200, Seattle, WA 98104; Tel: 206-576-6500; Fax: 206-215-5935; E-mail: [email protected] Primary pancreatic lymphoma is a rare malignancy that accounts for approximately 0.5% of pancreatic neoplasms. Primary pancreatic lymphoma is typically a circumscribed, solitary tumor that affects the pancreatic head and periampullary region. The diagnosis of primary pancreatic lymphoma is often unsuspected because of the rarity of this condition and the overlap in clinical, radiologic, and laboratory features between primary pancreatic lymphoma and carcinoma, which is a more common malignancy to affect the region. Because the clinical management, therapy, and prognosis of primary pancreatic lymphoma hinge on its diagnosis and classification, tumor sampling for histologic and immunophenotypic evaluation is essential; tumor samples can be obtained by imaging-guided, endoscopic, or surgical means. Chemotherapy is the mainstay of treatment. The clinical benefits of surgical intervention in primary pancreatic lymphoma need reappraisal, given the improved outcomes associated with aggressive combination chemotherapeutic regimens that include rituximab (Rituxan, Genentech).