Primary pancreatic anaplastic large cell lymphoma, ALK negative: a case report

• Published in: World journal of gastroenterology : WJG Vol. 11; no. 39; pp. 6221 - 6224
• Main Authors: Savopoulos, Christos-G, Tsesmeli, N-E, Kaiafa, G-D, Zantidis, A-T, Bobos, M-T, Hatzitolios, A-I, Papavramidis, S-T, Kostopoulos, I-S
• Format: Journal Article
• Language: English
• Published: United States 1st Medical Propedeutic Department,AHEPA Hospital,Aristotle University of Thessaloniki,St. Kyriakidi 1,Thessaloniki 54636,Greece%Department of Pathology,Aristode University Medical School,Thessaloniki 54006,Greece%3rd Department of Surgery,AHEPA Hospital,Aristotle University of Thessaloniki,St. Kyfiakidi 1,Thessaloniki 54636,Greece 21.10.2005; Baishideng Publishing Group Inc
• Subjects: Aged, 80 and over; Anaplastic Lymphoma Kinase; Carcinoma - metabolism; Carcinoma - pathology; Case Report; Fatal Outcome; Humans; Lymphoma, Large B-Cell, Diffuse - metabolism; Lymphoma, Large B-Cell, Diffuse - pathology; Male; Pancreatic Neoplasms - metabolism; Pancreatic Neoplasms - pathology; Protein-Tyrosine Kinases - metabolism; Receptor Protein-Tyrosine Kinases; Anaplaslic large cell lymphoma; Lactate dehydrogenase; β2 microglobulin; Primary pancreatic lymphoma
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v11.i39.6221

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 beta (2) 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 beta(2) microglobulin.