PRIMARY PANCREATIC NON-HODGKINS-LYMPHOMAS

Primary pancreatic lymphomas are rare. We reviewed our experience at K ing Faisal Specialist Hospital and Research Center; the hospital tumor registry identified five patients with primary pancreatic lymphoma am ong the 1,212 adult non-Hodgkin's (NHL) cases referred to this institu te during 1987-1994. The histology was diffuse large cell in all cases . According to the Ann Arbor classification, four patients had stage I E and one patient stage IIE disease. The diagnosis was established by laparotomy in three and ultrasound or CT-guided biopsy in two patients . All patients received chemotherapy. Radiotherapy was used in two cas es; in one patient the pancreatic bed was irradiated, whereas in the o ther radiation was given for obstructive jaundice. Four patients are a live with no evidence of disease at 84, 26, 24, and 21 months follow-u p. One patient relapsed at 12 months following chemotherapy and is ali ve with disease at 23 months follow-up. The clinical and radiological findings in primary pancreatic NHL are not pathognomonic, and the diag nosis is only established on histopathological examination. The manage ment should be nonsurgical as the response to chemotherapy and radiati on appears to be no different from NHL at other sites.