Primary pancreatic lymphoma: Clinical presentation, diagnosis, treatment, and outcome.
chemotherapy
lymphoma
pancreas
surgery
Journal
European journal of haematology
ISSN: 1600-0609
Titre abrégé: Eur J Haematol
Pays: England
ID NLM: 8703985
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
12
03
2020
revised:
08
06
2020
accepted:
09
06
2020
pubmed:
17
6
2020
medline:
30
7
2021
entrez:
17
6
2020
Statut:
ppublish
Résumé
Primary pancreatic lymphoma (PPL) is a rare disease representing 0.1% of malignant lymphomas, which lacks well-defined diagnostic and therapeutic protocols. To describe PPL clinical, diagnostic and histological characteristics, together with therapy and outcome, in a relatively large series of patients. The study includes 39 PPL patients, aged ≥15 years, observed from January 2005 to December 2018, in 8 Italian Institutions. The main symptoms were abdominal pain (58%) and jaundice (47%). Lactate dehydrogenase serum levels were elevated in 43% of patients. Histological specimens were mostly obtained by percutaneous (41%) or endoscopic (36%) biopsy, with diffuse large B-cell lymphoma being the most frequent (69%) histological diagnosis. Chemotherapy was administered alone in 65% of patients, with radiotherapy in 17%, or after surgery in 9%. The 2-year overall survival (OS) was 62%, the 2-year progression-free survival (PFS) 44%. Debulking surgery (with or without chemotherapy) was associated with a significant worse OS. Three (9.4%) of 32 high-grade patients experienced a central nervous system (CNS) relapse. PPL is rare, often high-grade, with symptoms and localization similar to other pancreatic malignancies. Biopsy should be the preferred diagnostic method. High-grade PPL should undergo CNS prophylaxis.
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
468-475Informations de copyright
© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Références
Behrns KE, Sarr MG, Strickler JG Pancreatic lymphoma: is it a surgical disease? Pancreas. 1994;9:662-667.
Baylor SM, Berg JW Cross-classification and survival characteristics of 5,000 cases of cancer of the pancreas. J Surg Oncol. 1973;5:335-358.
Freeman C, Berg JW, Cutler SJ Occurrence and prognosis of extranodal lymphomas. Cancer. 1972;29:252-260.
Dawson IM, Cornes JS, Morson BC Primary malignant lymphoid tumours of the intestinal tract. Report of 37 cases with a study of factors influencing prognosis. Br J Surg. 1961;49:80-89.
Fléjou JF Classification OMS 2010 des tumeurs digestives: la quatrième édition [WHO Classification of digestive tumors: the fourth edition]. Ann Pathol. 2011;31(5 Suppl):S27-31.
Jones WF, Sheikh MY, McClave SA AIDS-related non-Hodgkin's lymphoma of the pancreas. Am J Gastroenterol. 1997;92:335-338.
Rad N, Khafaf A, Alizadeh AHM. Primary pancreatic lymphoma: what we need to know. J Gastrointest Oncol. 2017;8:749-757.
Manning MA, Paal EE, Srivastava A, Mortele KJ Nonepithelial neoplasms of the pancreas, part 2: malignant tumors and tumors of uncertain malignant potential from the radiologic pathology archives. Radiographics. 2018;38:1047-1072.
Mishra MV, Keith SW, Shen X, Ad VB, Champ CE, Biswas T Primary pancreatic lymphoma. Am J Clin Oncol. 2013;36:38-43.
Sadot E, Yahalom J, Do RKG, et al. Clinical features and outcome of primary pancreatic lymphoma. Ann Surg Oncol. 2015;22:1176-1184.
Mohamadnejad M, Khosravi P, Khani M, Nikmanesh A, Eloubeidi MA. Primary pancreatic Hodgkin's lymphoma diagnosed on EUS-guided FNA. Gastrointest Endosc. 2016;83:844-845.
Matsubayashi H, Takagaki S, Otsubo T, et al. Pancreatic T-cell lymphoma with high level of soluble interleukin-2 receptor. J Gastroenterol. 2002;37:863-867.
Carbonetti F, Iannicelli E, Federici M, et al. Primary pancreatic Burkitt lymphoma presenting as acute pancreatitis. J Gastrointest Cancer. 2014;45(Suppl 1):265-269.
Yoon WJ, Yoon YB, Kim YJ, Ryu JK, Kim YT. Primary pancreatic lymphoma in Korea-A single center experience. J Korean Med Sci. 2010;25:536-540.
Arcari A, Anselmi E, Bernuzzi P, et al. Primary pancreatic lymphoma. A report of five cases. Haematologica. 2005;90(1):ECR09.
Swerdlow SH, Campo E, Pileri SA, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127:2375-2390.
Cheson BD, Fisher RI, Barrington SF, et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol. 2014;32:3059-3068.
Kanno A, Masamune A, Hanada K, Kikuyama M, Kitano M Advances in early detection of pancreatic cancer. Diagnostics. 2019;9:18.
de Pretis N, Amodio A, Frulloni L Updates in the field of autoimmune pancreatitis: a clinical guide. Expert Rev Gastroenterol Hepatol. 2018;12:705-709.
Boninsegna E, Zamboni GA, Facchinelli D, et al. CT imaging of primary pancreatic lymphoma: experience from three referral centres for pancreatic diseases. Insights Imaging. 2018;9:17-24.
Chaganti S, Illidge T, Barrington S, et al. Guidelines for the management of diffuse large B-cell lymphoma. Br J Haematol. 2016;174:43-56.
Maurer MJ, Ghesquières H, Jais J-P, et al. Event-free survival at 24 months is a robust end point for disease-related outcome in diffuse large B-cell lymphoma treated with immunochemotherapy. J Clin Oncol. 2014;32:1066-1073.
Liakakos T, Misiakos EP, Tsapralis D, Nikolaou I, Karatzas G, Macheras A A role for surgery in primary pancreatic B-cell lymphoma: a case report. J Med Case Rep. 2008;2:167.
Vitolo U, Seymour JF, Martelli M, et al. Extranodal diffuse large B-cell lymphoma (DLBCL) and primary mediastinal B-cell lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2016;27(Suppl 5):mdw175.
Ollila TA, Olszewski AJ Extranodal diffuse large B cell lymphoma: molecular features, prognosis, and risk of central nervous system recurrence. Curr Treat Options Oncol. 2018;19:38.