Primary Pancreatic Lymphoma Masquerading as Carcinoma

Adenocarcinoma is the most common primary pancreatic neoplasm type, followed by secondary pancreatic lymphoma andprimary pancreatic lymphoma (PPL). PPL is associated with peripancreatic lymphadenopathy and usually presents as ahomogenous mass with extrapancreatic invasion into surrounding structures. However, localized involvement of the distalpancreas is uncommon, and diffuse involvement of the pancreas is even rarer. Herein, we present the case of a 53-year-oldwoman with PPL of the uncinate process with biliary obstruction mimicking pancreatic adenocarcinoma, successfully diagnosednonoperatively. Abdominal computed tomography showed an ill-defined uncinate process mass, hypodense with mildenhancement (3:9×3:4×3:5cm), infiltrating the second and third parts of the duodenum. Biopsy revealed NHL with noevidence of adenocarcinoma. PPL was diagnosed. She received chemotherapy with a CHOP (cyclophosphamide, doxorubicin,vincristine, and prednisone) protocol with rituximab, which she tolerated with no clinical or radiological evidence of recurrenceat 1-year follow-up.