Primary pancreatic lymphoma: a rare cause of massive upper gastrointestinal hemorrhage.

摘要

A 68-year-old man presented with abdominal pain radiating to the back associated with a 25 kg weight loss. Abdominal ultrasound and computed tomography (CT) revealed an 8 cm partially cystic mass in the pancreatic head that encased the aorta and inferior vena cava (IVC) (Figure 1). A CT-guided fine-needle aspiration (FNA) was performed and confirmed a diagnosis of diffuse large B cell lymphoma. Subsequent staging CT demonstrated peripancreatic lymphadenopathy and air within the tumour, suggesting a possible communication between the intestine and the pancreatic mass. Direct visualization with gastroscopy confirmed a large penetrating ulcer between the second portion of the duodenum and the pancreatic tumour (Figure 2).