Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Case report
Year : 2017 | Month : September | Volume : 11 | Issue : 9 | Page : PD09 - PD11

An Aggressive Primary Retroperitoneal Diffuse Large B-Cell Lymphoma Mimicking a Pancreatic Neoplasm, Presenting as Duodenal Stenosis

Bharadhwaj Ravindhran, Clement Prakash, Sridar Govindharaj, Noor Mohammed Shawnaz Bahnou, B Pavithra

1. Junior Resident, Department of Surgery, St John's Medical College, Bengaluru, Karnataka, India. 2. Assistant Professor, Department of Surgery, St John's Medical College, Bengaluru, Karnataka, India. 3. Professor, Department of Surgery, St John's Medical College, Bengaluru, Karnataka, India. 4. Associate Professor, Department of Surgery, St John's Medical College, Bengaluru, Karnataka, India. 5. Senior Resident, Department of Surgery, St John's Medical College, Bengaluru, Karnataka, India.

Correspondence Address :
Dr. Bharadhwaj Ravindhran,
123 Richfield Apartments, Outer Ring Road, Marathahalli, Bengaluru-560037, Karnataka, India.
E-mail: bharadhwaj.r@stjohns.in

Abstract

Diffuse Large B-Cell Lymphoma (DLBCL) is the most common histological subtype of Non-Hodgkin’s Lymphoma (NHL). Primary retroperitoneal DLBCL is uncommon and has seldom been reported. Extrinsic compression of the duodenum due to lesions originating from the retroperitoneum is also rare. We present a case of a 39-year-old man who presented with inability to tolerate oral intake, abdominal pain, an upper abdominal mass and postprandial bilious vomiting caused by a large DLBCL arising from the retroperitoneum causing extrinsic compression of the duodenum. The cause of compression was initially presumed to be a neoplasm arising from the uncinate process of the pancreas or duodenum because of its proximity to the uncinate process and apparent widening of the C loop of duodenum. Repeat Computed Tomography (CT) scans were obtained because of the rapid increase in the size of the mass, normal levels of tumour markers such as Cancer Antigen (CA) 19-9, Carcinoembryonic Antigen (CEA) and no evidence of jaundice in spite of the large size of the mass. It revealed encasement of the uncinate process of pancreas with no involvement of parenchyma of the pancreas, thereby mimicking a pancreatic tumour. The neoplastic lymphoid cells were positive for Leukocyte Common Antigen (LCA), Cluster of Differentiation (CD)20, CD10, B-cell Lymphoma 2 (Bcl-2) and were negative for Creatine Kinase (CK), CD23, CD30, Anaplastic Lymphoma Kinase (ALK) and cyclin D1, D3 and D5. The Ki67 proliferative index was greater than 95%. Retroperitoneal DLBCL although rare should be considered in cases of duodenal obstruction.

Keywords

Extrinsic compression, Non-hodgkin’s lymphoma, Retroperitoneum

How to cite this article :

Bharadhwaj Ravindhran, Clement Prakash, Sridar Govindharaj, Noor Mohammed Shawnaz Bahnou, B Pavithra. AN AGGRESSIVE PRIMARY RETROPERITONEAL DIFFUSE LARGE B-CELL LYMPHOMA MIMICKING A PANCREATIC NEOPLASM, PRESENTING AS DUODENAL STENOSIS. Journal of Clinical and Diagnostic Research [serial online] 2017 September [cited: 2018 Jan 18 ]; 11:PD09-PD11. Available from
http://www.jcdr.net/back_issues.asp?issn=0973-709x&year=2017&month=September&volume=11&issue=9&page=PD09-PD11&id=10611

DOI and Others

DOI: 10.7860/JCDR/2017/27222.10611

Date of Submission: Feb 07, 2017
Date of Peer Review: Apr 25, 2017
Date of Acceptance: Jul 05, 2017
Date of Publishing: Sep 01, 2017

FINANCIAL OR OTHER COMPETING INTERESTS: None.

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