Spontaneously Complete Regression Of Pseudolymphoma Of The Remnant Pancreas After Pancreaticoduodenectomy.

Nakata, B. 2012Pancreatic cancer

Nakata, B., Amano, R., Matsuoka, J., Sugimori, S., Ohsawa, M., Wakasa, K., Egashira, Y., Kimura, K., Yamada, N., & Hirakawa, K. (2012). spontaneously complete regression of pseudolymphoma of the remnant pancreas after pancreaticoduodenectomy. Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 12(3), 215–218. https://doi.org/10.1016/j.pan.2012.02.011

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Abstract

BACKGROUND: Pancreatic pseudolymphoma is extremely rare. METHOD: We present multiple pseudolymphomas in the head and body of the pancreas. The hypoechoic lesions observed by endoscopic ultrasound were enhanced in late-phase angio-computed tomography and homogeneously hypointensive in T1-weighted magnetic resonance imaging (MRI). (18)F-fluorodeoxyglucose positron emission tomography showed strong accumulation in the lesions. The lesions were suspected to be non-functioning islet cell carcinoma. The intraoperative pathological diagnosis for the specimen obtained by a pylorus-preserving pancreaticoduodenectomy was non-neoplastic lymphoid cells. The remnant lesion in the pancreatic body was preserved. RESULTS: Macroscopically, the mass was well-circumscribed gray-white colored lesion. The pathological diagnosis was pancreatic pseudolymphoma. The lesion in the remnant pancreas spontaneously disappeared within one year after the operation. CONCLUSION: The differential diagnosis of pancreatic pseudolymphoma from malignant tumor is very difficult, however, the image findings demonstrated here may be informative. The spontaneous disappearance of pancreatic pseudolymphoma was firstly observed in the present case.

Case Details

Disease Location

Pancreas

Personal Characteristics

51-year-old woman with renal stones

Clinical Characteristics

Us showed a hypoechoic mass 15 mm in diameter was observed in the pancreatic head. Further examination using endoscopic ultrasound (eus) demonstrated two well-defined homogeneous hypoechoic lesions 17 and 10 mm in diameter in the pancreatic head and one lesion 23 mm in diameter in the pancreatic body. The preoperative diagnosis was multiple non-functioning islet cell tumors of the pancreas. Pylorus-preserving pancreaticoduodenectomy was performed in order to acquire an intraoperative pathological diagnosis for the pancreatic head lesions

Remission Characteristics

Pathological findings using frozen sections revealed that the mass was composed predominantly of non-neoplastic lymphoid cells with proliferative interstitial tissue that had grown to compress the normal pancre- atic tissue.