Case Report
Copyright ©The Author(s) 2005. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 21, 2005; 11(39): 6221-6224
Published online Oct 21, 2005. doi: 10.3748/wjg.v11.i39.6221
Primary pancreatic anaplastic large cell lymphoma, ALK negative: A case report
Christos G Savopoulos, NE Tsesmeli, GD Kaiafa, AT Zantidis, MT Bobos, AI Hatzitolios, ST Papavramidis, IS Kostopoulos
Christos G Savopoulos, NE Tsesmeli, GD Kaiafa, AT Zantidis, AI Hatzitolios, 1st Medical Propedeutic Department, AHEPA Hospital, Aristotle University of Thessaloniki, St. Kyriakidi 1, Thessaloniki 54636, Greece
MT Bobos, IS Kostopoulos, Department of Pathology, Aristotle University Medical School, Thessaloniki 54006, Greece
ST Papavramidis, 3rd Department of Surgery, AHEPA Hospital, Aristotle University of Thessaloniki, St. Kyriakidi 1, Thessaloniki 54636, Greece
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Christos G Savopoulos, 1st Medical Propedeutic Department, AHEPA Hospital, Aristotle University of Thessaloniki, St. Kyriakidi 1, Thessaloniki 54636, Greece.chrsavop@med.auth.gr
Telephone: +30-2310-994783 Fax: +30-2310-285128
Received: April 13, 2005
Revised: May 9, 2005
Accepted: May 12, 2005
Published online: October 21, 2005
Abstract

We present the fourth case of a primary pancreatic anaplastic large cell lymphoma (ALCL), ALK-. An 80-year-old man was admitted to our clinic for further investigation of a fever of unknown origin. He noted anorexia, weight loss and fatigue. His laboratory tests showed anemia and a great elevation of ESR, LDH, and β2 microglobulin. In CT and MRI scan, a soft tissue mass in the pancreas was observed. A repeated endoscopy after his admission revealed an ulcerated mass-like deformity of the duodenal bulb. Explorative laparotomy confirmed a diffuse spread of an unresectable malignant pancreatic mass extending to the adjacent organs. Duodenal and surgical biopsies identified an ALCL of T-cell lineage, ALK-. The patient died in the Intensive Care Unit due to hemodynamic instability. Our case is the first one indicating that primary pancreatic lymphoma should be suspected in a patient with pancreatic mass and elevated serum LDH and β2 microglobulin.

Keywords: Anaplastic large cell lymphoma, Primary pancreatic lymphoma, Lactate dehydrogenase, β2 microglobulin