摘要
瞄准：在临床的实践提高主要胰腺的淋巴瘤(PPL ) 的识别。方法：临床的演讲，成像特征和 PPL 病人的病理学的特征的回顾的评论被介绍，以及他们的诊断和治疗，在有文学评论的联合。结果：组织学的诊断被 EUS-FNA 被外科并且在二个病人在四个病人做。六个 PPL 病人(5 男性和 1 女性；年龄变化， 16-65 年；吝啬的年龄， 46 年) 有症状的持续时间二个星期到三个月。主要主要症状不特征，是腹的疼痛，腹的群众，重量损失，黄疸，恶心并且呕吐。病人之一开发了尖锐胰腺炎。在一个病人，浆液 CA19-9 的水平是 76.3 microg/L。腹的 CT 扫描证明六个肿瘤中的三个位于胰的头，二在里面身体和尾巴，和在整个胰的身体。在在四种情况中的胰的肿瘤的直径是超过 6 厘米，与同类的密度和不清楚的边阶。提高的 CT 扫描证明仅仅肿瘤边稍微被提高。胰腺的管不规则地在其肿瘤位于胰腺的头和身体的二种情况中被缩小，在哪个内视镜后退 cholangiopancreatography (ERCP ) 证明近似片断稍微被扩大。二个病人经历了惠普尔操作，一个病人经历了胰切除术，并且另一个病人经历了起作用的胆汁的解压缩。PPL 在舞台我在 2 个病人并且在在 4 个病人的阶段 II E 的 E 根据安乔木分类系统。B 房间 non-Hodgkin 的淋巴瘤的诊断在所有病人被成为组织病理学说的联盟者。所有六个病人经历了全身的化疗，其中一也与鲸鱼群妈辐射线测定被对待。一个病人二个星期在诊断以后死了，二个病人失去了后续，收到的化疗熬过 49 和 37 瞬间的二个病人，和留下的病人仍然是活着的 21 瞬间，在诊断和治疗以后。结论：PPL 是从胰腺的实质发源的额外的节的淋巴瘤的一种稀罕形式。临床并且成像调查结果另外不在胰腺的淋巴瘤和胰腺的癌症的区别是特定的，它值得注意。胰的指导 EUS 的好针的渴望(EUS-FNA ) 象先进免疫一样要求富有经验的 cytopathologists 在组织的小数量上获得最后的诊断的组织化学的试金。外科和辅助化疗或放射疗法能生产相当好的结果。
AIM： To heighten recognition of primary pancreatic lymphoma （PPL） in clinical practice. METHODS： A retrospective review of the clinical presentation, imaging characteristics and pathological features of PPL patients were presented, as well as their diagnosis and treatment, in combination with literature review. RESULTS： Histological diagnosis was made in four patients by surgery and in two patients by EUS-FNA. The six PPL patients （5 males and 1 female; age range, 16-65 years; mean age, 46 years） had the duration of symptoms for two weeks to three months. The primary presenting symptoms, though not characteristic, were abdominal pain, abdominal masses, weight loss, jaundice, nausea and vomiting. One of the patients developed acute pancreatitis. In one patient, the level of serum CA19-9 was 76.3 μg/L. Abdominal CT scan showed that three of the six tumors were located in the head of pancreas, two in the body and tail, and one throughout the pancreas. Diameter of the tumors in the pancreas in four cases was more than 6 cm, with homogeneous density and unclear borders. Enhanced CT scan showed that only the tumor edges were slightly enhanced. The pancreatic duct was irregularly narrowed in two cases whose tumors were located in the pancreatic head and body, in which endoscopic retrograde cholangiopancreatography （ERCP） showed that the proximal segment was slightly dilated. Two patients underwent Whipple operation, one patient underwent pancreatectomy, and another patient underwent operative biliary decompression. PPL was in stage Ⅰ E in 2 patients and in stage Ⅱ E in 4 patients according to the Ann Arbor classification system. The diagnosis of B-cell non-Hodgkin＇s lymphoma was made in all patients histopathologically. All six patients underwent systemic chemotherapy, one of whom was also treated with gamma radiometry. One patient died two weeks after diagnosis, two patients lost follow-up, two patients who received chemotherapy survived 49 and 37 mo, and the remaining patient is still alive 21 mo, after diagnosis and treatment. CONCLUSION： PPL is a rare form of extranodal lymphoma originating from the pancreatic parenchyma. Clinical and imaging findings are otherwise not specific in the differentiation of pancreatic lymphoma and pancreatic cancer, which deserves attention. EUS-guided fine-needle aspiration （EUS-FNA） of the pancreas requires experienced cytopathologists as well as advanced immunohistochemical assays to obtain a final diagnosis on a small amount of tissue. Surgery and adjuvant chemotherapy or radiotherapy can produce fairly good outcomes.
