2019 Volume 61 Issue 8 Pages 1576-1581
A 32-year-old woman with epigastric pain, back pain, and hyperamylasemia (1,627 IU/L) was referred to our hospital. Computed tomography (CT) revealed a 43 × 37-mm hypovascular mass in the pancreas head, dilated tail of the main pancreatic duct, and enlarged mesenteric and paraaortic lymph nodes. Upper gastrointestinal endoscopy revealed a white, granular, small elevated lesion in the duodenum, which was thought to be duodenal follicular lymphoma. The patient also developed obstructive acute pancreatitis due to enlarged lymph nodes around the pancreas, which was treated with placement of a pancreatic duct stent. Positron emission tomography-CT showed abnormal uptake in the pancreatic mass, in a right axillary lymph node, and in bilateral inguinal and intraabdominal lymph nodes. The soluble interleukin (IL)-2 receptor level was also elevated. Transformation of follicular lymphoma which was diagnosed from the pathological findings of the right axillary lymph node, was treated with the R-CHOP regimen.
