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Ultrasound Journal 7 - ?? ??? ?? ???(Rare Primary Pancreatic Lymphoma)? ??? ?? ??? ??(CEUS) ??

2022-11-15

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  • ? ??? ?(Primary Pancreatic lymphoma)? ??? ?? ???.
  • CEUS??? ??? ?(PPL) ??? ??? ??? ? ? .

Case Description:

64?? ? ??? ?? ?? ???(left upper quadrant) ? ? ??? ? ??? B ?? " ? ???(heterogeneous hypoechogenicit) ? ?? ?? ?? ?? "? ?. ?? ??? ?? ??? CT? MRI ??? ?? ?? ?? , ??, ?? ?? ???. ? ?, ?? ??, ?(TMs) ??? ?? ???. ??? ?? Zhejiang ?? ?2 ?? ??? ?? ??? ?.

:

??? US, CEUS, CT ? ?? PET/CT ??? ? ??? Fig 1-3? .

pancreatic-lymphoma-fig1-pc
??1: B-?? ??? ? (splenic parenchyma)? ???(splenic hilum)? ??? ??(heterogeneous mass)? ?? ??(pancreatic tail) ??? ?? ??(heterogeneous pancreas)? ???. (Fig 1 A). ? ??(Color Doppler imaging ; CDI) ? ?? ??(mass)? ??? ? (Fig 1 B). ?? ??(pancreatic mass)? ??? CEUS ??? ???(arterial phase)?? (heterogeneous hyperenchancement)? ???(delayed phase)?? ?? ??(rapid fading)? ?? ??(sieve-like) ??? . (Fig 1 C-F)
pancreatic-lymphoma-fig2-pc
??2: CT ?? ?? ??? ??? ?? ??(pancreatic tail)?? ??, ??(spleen)?? ??? ?? ???(splenic hilum), ?? ?? ??? ?? ??? ?? ???. (Fig 2 A). ??? ?? ??? ??? ?? (Fig 2 B-C). ??(spleen), ?? ?? ? ??(intestinal tract) ??? ?? ??? ???(coronal plane)?? ???. (Fig 2 D)
pancreatic-lymphoma-fig3-pc
??3: ?? PET/CT?? (pancreatic tail), ??, ?? ??, ?? ??(splenorenal space), ?? ? ??(splenogastric space)? ??? ??(soft tissue masses )? ?? ??? ??? ??? ?? ???

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?? ?? ??? ??? (nonspecific) ??? ???(primary pancreatic cancer)?? ? ??? ?? ???(primary pancreatic lymphoma)? ?(Burkitt lymphoma)? ??? ?? ?? ??(pancreatic mass)? ?? ???(ultrasound guided biopsy)? ???.

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??? ?? R-Hyper-CVAD-A ? ??? CT ??? ?? ?? ??? ??? ??? ?? ?? ? ? . (Fig 4 A-C). ??? ??? ?? ??? ??.

pancreatic-lymphoma-fig4-pc
??4. ??? CT?? ?? ??? ?? ???(A) ?? ? (B) ?? 1?? ?, (C) ?? 2?? ?

??:

??? ?? ?? ?? ? ?? ?? ?? ?? ?? ? 0.5%, ?? ???(extranodal lymphomas )? 2%? ?. [1] ? ??? ??? (non-specific)?? ? ???(pancreatic ductal adenocarcinoma) ? ?? ?? ? ?? ??? ??[2].


?? , Resona ??? CEUS Pintong ??? ?? ?? ? ?? ??? ?? ??? ? ?. ? , CEUS ???(delayed phase)? ?? ??(sieve-like) ??? ??? ??? ?? CEUS ??? ??? ?? CEUS ??? ??? ??? ? ? . ?? ??? ??? (Ultra-guided biopsy) ?? ??? ???(exploratory laparotomy)? ?? ?? ??(histopathological examination)? ?? ??? ? .

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[1] K Blouhos, K A Boulas, A Paraskeva, et al. Obstructive jaundice as primary presentation of a stage IIE Non-Hodgkin lymphoma: A decision making process between advanced lymphoma and locally advanced/metastatic pancreatic adenocarcinoma [J]. International Journal of Surgery Case Reports. 2018,44:226-229.
[2] Han Huan, Wang Yuanchen, Zheng Jianming. A nine-case report of clinicopathological analysis of primary pancreatic lymphoma [J]. Chinese Journal of Pancreatology, 2018,18(1):51-53.