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A case report of diffuse large B cell lymphoma presenting as acute pancreatitis

Xianguang Huang, Guangyao Wu, Xiaohong Cen, Zongquan Wen, Xiaodong Lin, Songhu Li, Fu Zhang, Shaoping Yu

Background: Diffuse large B-cell lymphoma, a common type of non-Hodgkin’s lymphoma, constitutes 30%-58% of lymphoma series. Lymphoma involved with pancreas is rare.

Case report: A 58 y old woman was with diffuse large B-cell lymphoma presenting as acute pancreatitis. The patient was with no history of gallbladder stone or common bile conduct obstruction. After ruled out common causes of pancreatitis, such as bile stones, alcohol consumption and hypertriglyceridemia, she was highly suspect of secondary pancreatitis. Further test, imaging and pathology and immunohistochemistry confirmed diffuse large B cell lymphoma was a rate presentation of acute pancreatitis. Within a week after treatment, the patient’s abdominal pain has been resolved. After 1 w after treatment, the serum amylase level and serum lipase were decreased to 47 μ/l and 96 μ/l, respectively. Moreover, the C reaction protein and low density lipoprotein-cholesterol were regulated to normal level. A follow-up CT scan revealed a significant decrease in the size of retroperitoneal lymph and pancreas nodes. On the last follow up at 10 month, her abdominal pain was relieved completely.

Conclusion: Diffuse large B cell lymphoma can be a rate presentation of acute pancreatitis and timely evaluation can be effective in early diagnosis and successful treatment as in our case.