Multiple Malignant Lymphomas of the Bile Duct Developing after Spontaneous Regression of an Autoimmune Pancreatitis-like Mass

Koushiro Ohtsubo; Kaname Yamashita; Naohiro Yanagimura; Chiaki Suzuki; Azusa Tanimoto; Akihiro Nishiyama; Shinji Takeuchi; Noriko Iwaki; Mitsuhiro Kawano; Akira Izumozaki; Dai Inoue; Toshifumi Gabata; Hiroko Ikeda; Michio Watanabe; Seiji Yano

doi:10.2169/internalmedicine.5429-20

CASE REPORTS

Multiple Malignant Lymphomas of the Bile Duct Developing after Spontaneous Regression of an Autoimmune Pancreatitis-like Mass

Koushiro Ohtsubo, Kaname Yamashita, Naohiro Yanagimura, Chiaki Suzuki, Azusa Tanimoto, Akihiro Nishiyama, Shinji Takeuchi, Noriko Iwaki, Mitsuhiro Kawano, Akira Izumozaki, Dai Inoue, Toshifumi Gabata, Hiroko Ikeda, Michio Watanabe, Seiji Yano

Author information

Koushiro Ohtsubo
Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan
Kaname Yamashita
Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan
Naohiro Yanagimura
Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan
Chiaki Suzuki
Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan
Azusa Tanimoto
Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan
Akihiro Nishiyama
Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan
Shinji Takeuchi
Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan
Noriko Iwaki
Department of Hematology, Kanazawa University, Japan
Mitsuhiro Kawano
Department of Rheumatology, Kanazawa University, Japan
Akira Izumozaki
Department of Radiology, Kanazawa University, Japan
Dai Inoue
Department of Radiology, Kanazawa University, Japan
Toshifumi Gabata
Department of Radiology, Kanazawa University, Japan
Hiroko Ikeda
Division of Human Pathology, Kanazawa University, Japan
Michio Watanabe
Gastroenterology, Hoju Memorial Hospital, Japan
Seiji Yano
Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan

Keywords: non-Hodgkin lymphoma, high-grade B-cell lymphoma, with MYC and BCL2 and/or BCL6 rearrangements, bile duct, automiine pancreatitis, IgG4-related disease

JOURNAL OPEN ACCESS

2021 Volume 60 Issue 3 Pages 409-415

DOI https://doi.org/10.2169/internalmedicine.5429-20

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Abstract

We herein report a 67-year-old woman with malignant lymphomas of the bile duct that developed after regression of a pancreatic head mass. Computed tomography suggested the mass was pancreatic head cancer. Endoscopic ultrasonography showed a low-echoic mass with hyperechoic strands resembling autoimmune pancreatitis. Her serum IgG4 concentration was elevated to 674 mg/dL. After the pancreatic head mass spontaneously diminished, three masses were detected in the common bile duct. A biopsy of the major papilla revealed high-grade B-cell lymphoma with MYC, BCL2 and/or BCL6 rearrangement. Systemic chemotherapy with rituximab plus etoposide, prednisolone, vincristine, cyclophosphamide and doxorubicin resulted in complete remission.

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