RT Journal Article
SR Electronic
T1 Acute pancreatitis as an unusual presentation of primary splenic lymphoma
JF BMJ Case Reports
FD BMJ Publishing Group Ltd
SP bcr-2017-222643
DO 10.1136/bcr-2017-222643
VO 2017
A1 Gravito-Soares, Elisa
A1 Gravito-Soares, Marta
A1 Pina-Cabral, José Eduardo
A1 Tomé, Luis
YR 2017
UL http://casereports.bmj.com/content/2017/bcr-2017-222643.abstract
AB A 51-year-old man with no relevant medical history presents to the emergency department complaining of a recent worsening of few months upper abdominal pain with back radiation and postprandial fullness, without B symptoms. Laboratory analysis showed hyperamylasaemia, elevated lactate dehydrogenase and inflammatory parameters. Abdominal ultrasonography revealed a heterogeneous solid mass in the spleen/splenic hilum with pancreatic parenchyma continuity and no biliary tract dilation or gallstones. A mild acalculous acute pancreatitis diagnosis was made. Abdominopelvic CT revealed a large heterogeneous mass infiltrating the spleen and pancreas and obstructing the common bile duct at the pancreatic level with upstream dilation of biliary and pancreatic ducts, with splenic vein invasion. Several necrotic, peripancreatic and hepatic hilar adenopathies were also observed. Ultrasound-guided biopsy showed a primary splenic diffuse large B-cell non-Hodgkin’s lymphoma. Chemotherapy with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone) was performed with lack of response and the patient died within 10 months of diagnosis onset.