A case of malignant lymphoma with diffuse swelling of the pancreas

Abstract

A 83-year-old man was admitted to our hospital with the complaint of upper abdominal fullness in September 2004. Diffuse swelling of the pancreas and diffuse irregular narrowing of the main pancreatic duct were observed. Although these findings suggested that he was suffering from autoimmune pancreatitis, neither anti-nuclear antigen nor an increased level of IgG/IgG4 was detected. In October, he complained of severe constipation. Examination revealed the appearance of ascites and thickened rectal wall. Because lymphoma cells were detected both in the ascites and the rectum, and a high level of soluble IL-2 receptor (3,183U/ml) was found serologically, the patient was diagnosed as malignant lymphoma. Chemotherapy improved the pancreas swelling and narrowing of the main pancreatic duct, but the patient died in January 2005 from respiratory distress. We review malignant lymphoma of the pancreas in Japan.