MR features of primary and secondary malignant lymphoma of the pancreas: a pictorial review

Insights into Imaging - Tập 4 - Trang 321-329 - 2013
Yasunari Fujinaga1,2, Chandana Lall2, Aashish Patel3, Tsuyoshi Matsushita1, Rupan Sanyal4, Masumi Kadoya1
1Department of Radiology, Shinshu University School of Medicine, Matsumoto, Japan
2Department of Radiological Sciences, University of California, Irvine, Medical Center, Orange, USA
3Department of Radiology, Abdominal Imaging, Indiana University Medical Center, Indianapolis, USA
4Department of Diagnostic Radiology, Abdominal Imaging, Cleveland Clinic Hospitals, Cleveland, USA

Tóm tắt

To describe the imaging findings of primary and secondary pancreatic malignant lymphoma on magnetic resonance imaging (MRI), to help differentiate lymphoma of the pancreas from primary adenocarcinoma and autoimmune pancreatitis among others, and to discuss a few atypical presentations of pancreatitis mimicking lymphoma. Knowledge of these imaging manifestations of lymphoma may be helpful to arrive at an accurate diagnosis and avoid unnecessary morbidity and mortality from inadvertent surgery. • Pancreatic malignant lymphoma is shown as a nodular low-density area with mild enhancement on CT. • It sometimes shows variable manifestations mimicking other tumours and inflammatory conditions. • MRI provides useful information for differentiating malignant lymphoma from other mimickers.

Tài liệu tham khảo

Behrns KE, Sarr MG, Strickler JG (1994) Pancreatic lymphoma: is it a surgical disease? Pancreas 9(5):662–667

Weingrad DN, Decosse JJ, Sherlock P, Straus D, Lieberman PH, Filippa DA (1982) Primary gastrointestinal lymphoma: a 30-year review. Cancer 49(6):1258–1265

Tanaka T, Matsugu Y, Koide K et al (1996) Malignant lymphoma of the pancreas. Dig Dis Sci 41(2):402–404

Isaacson PG (1999) Gastrointestinal lymphomas of T- and B-cell types. Mod Pathol 12(2):151–158

Teefey SA, Stephens DH, Sheedy PF 2nd (1986) CT appearance of primary pancreatic lymphoma. Gastrointest Radiol 11(1):41–43. doi:10.1007/BF02035029

Tuchek JM, De Jong SA, Pickleman J (1993) Diagnosis, surgical intervention, and prognosis of primary pancreatic lymphoma. Am Surg 59(8):513–518

Freeman C, Berg JW, Cutler SJ (1972) Occurrence and prognosis of extranodal lymphomas. Cancer 29(1):252–260

Takahashi H, Tomita N, Yokoyama M et al (2012) Prognostic impact of extranodal involvement in diffuse large B-cell lymphoma in the rituximab era. Cancer 118(17):4166–4172. doi:10.1002/cncr.27381

Nakamura E, Shimizu M, Itoh T, Manabe T (2001) Secondary tumors of the pancreas: clinicopathological study of 103 autopsy cases of Japanese patients. Pathol Int 51(9):686–690

Dodd GD 3rd, Greenler DP, Confer SR (1992) Thoracic and abdominal manifestations of lymphoma occurring in the immunocompromised patient. Radiol Clin N Am 30(3):597–610

Radin DR, Esplin JA, Levine AM, Ralls PW (1993) AIDS-related non-Hodgkin’s lymphoma: abdominal CT findings in 112 patients. AJR Am J Roentgenol 160(5):1133–1139

Jones WF, Sheikh MY, McClave SA (1997) AIDS-related non-Hodgkin’s lymphoma of the pancreas. Am J Gastroenterol 92(2):335–338

Merkle EM, Bender GN, Brambs HJ (2000) Imaging findings in pancreatic lymphoma: differential aspects. AJR Am J Roentgenol 174(3):671–675

Saif MW (2006) Primary pancreatic lymphomas. JOP 7(3):262–273

Cario E, Runzi M, Metz K, Layer P, Goebell H (1997) Diagnostic dilemma in pancreatic lymphoma. Case report and review. Int J Pancreatol 22(1):67–71. doi:10.1007/BF02803907

Du X, Zhao Y, Zhang T et al (2011) Primary pancreatic lymphoma: a clinical quandary of diagnosis and treatment. Pancreas 40(1):30–36. doi:10.1097/MPA.0b013e3181e6e3e5

Arcari A, Anselmi E, Bernuzzi P et al (2005) Primary pancreatic lymphoma. Report of five cases. Haematologica 90(2):ECR09

Nayer H, Weir EG, Sheth S, Ali SZ (2004) Primary pancreatic lymphomas: a cytopathologic analysis of a rare malignancy. Cancer 102(5):315–321. doi:10.1002/cncr.20488

Sandrasegaran K, Lin C, Akisik FM, Tann M (2010) State-of-the-art pancreatic MRI. AJR Am J Roentgenol 195(1):42–53. doi:10.2214/AJR.10.4421

Gabata T, Matsui O, Kadoya M et al (1994) Small pancreatic adenocarcinomas: efficacy of MR imaging with fat suppression and gadolinium enhancement. Radiology 193(3):683–688

Mergo PJ, Helmberger TK, Buetow PC, Helmberger RC, Ros PR (1997) Pancreatic neoplasms: MR imaging and pathologic correlation. Radiographics 17(2):281–301

Kartalis N, Loizou L, Edsborg N, Segersvard R, Albiin N (2012) Optimising diffusion-weighted MR imaging for demonstrating pancreatic cancer: a comparison of respiratory-triggered, free-breathing and breath-hold techniques. Eur Radiol 22(10):2186–2192. doi:10.1007/s00330-012-2469-3

Schoennagel BP, Habermann CR, Roesch M et al (2011) Diffusion-weighted imaging of the healthy pancreas: apparent diffusion coefficient values of the normal head, body, and tail calculated from different sets of b-values. J Magn Reson Imaging 34(4):861–865. doi:10.1002/jmri.22743

Fukukura Y, Takumi K, Kamimura K et al (2012) Pancreatic adenocarcinoma: variability of diffusion-weighted MR imaging findings. Radiology 263(3):732–740. doi:10.1148/radiol.120111222

Kim JH, Hong SS, Eun HW, Han JK, Choi BI (2012) Clinical usefulness of free-breathing navigator-triggered 3D MRCP in non-cooperative patients: comparison with conventional breath-hold 2D MRCP. Eur J Radiol 81(4):e513–e518. doi:10.1016/j.ejrad.2011.06.004

Mitchell DG, Stolpen AH, Siegelman ES, Bolinger L, Outwater EK (1996) Fatty tissue on opposed-phase MR images: paradoxical suppression of signal intensity by paramagnetic contrast agents. Radiology 198(2):351–357

Cappell MS, Yao F, Cho KC, Axiotis CA (1989) Lymphoma predominantly involving the pancreas. Dig Dis Sci 34(6):942–947

Ishigami K, Tajima T, Nishie A et al (2010) MRI findings of pancreatic lymphoma and autoimmune pancreatitis: a comparative study. Eur J Radiol 74(3):e22–e28. doi:10.1016/j.ejrad.2009.03.022

Lui PC, Wong GK, Poon WS, Tse GM (2003) Intravascular lymphomatosis. J Clin Pathol 56(6):468–470

Sugiyama Y, Fujinaga Y, Kadoya M et al (2012) Characteristic magnetic resonance features of focal autoimmune pancreatitis useful for differentiation from pancreatic cancer. Jpn J Radiol 30(4):296–309. doi:10.1007/s11604-011-0047-2

Muhi A, Ichikawa T, Motosugi U et al (2012) Mass-forming autoimmune pancreatitis and pancreatic carcinoma: differential diagnosis on the basis of computed tomography and magnetic resonance cholangiopancreatography, and diffusion-weighted imaging findings. J Magn Reson Imaging 35(4):827–836. doi:10.1002/jmri.22881

Hur BY, Lee JM, Lee JE et al (2012) Magnetic resonance imaging findings of the mass-forming type of autoimmune pancreatitis: comparison with pancreatic adenocarcinoma. J Magn Reson Imaging 36(1):188–197. doi:10.1002/jmri.23609

Lin H, Li SD, Hu XG, Li ZS (2006) Primary pancreatic lymphoma: report of six cases. World J Gastroenterol 12(31):5064–5067

Wang YJ, Jeng CM, Wang YC, Chang PP, Wang TH (2006) Primary pancreatic Burkitt’s lymphoma mimicking carcinoma with obstructive jaundice and very high CA19-9. Eur J Gastroenterol Hepatol 18(5):537–540

Sata N, Kurogochi A, Endo K, Shimura K, Koizumi M, Nagai H (2007) Follicular lymphoma of the pancreas: a case report and proposed new strategies for diagnosis and surgery of benign or low-grade malignant lesions of the head of the pancreas. JOP 8(1):44–49

Van Beers B, Lalonde L, Soyer P et al (1993) Dynamic CT in pancreatic lymphoma. J Comput Assist Tomogr 17(1):94–97

Amodio J, Brodsky JE (2010) Pediatric Burkitt lymphoma presenting as acute pancreatitis: MRI characteristics. Pediatr Radiol 40(5):770–772. doi:10.1007/s00247-009-1475-3

Irie H, Honda H, Baba S et al (1998) Autoimmune pancreatitis: CT and MR characteristics. AJR Am J Roentgenol 170(5):1323–1327

Fujinaga Y, Kadoya M, Kawa S et al (2010) Characteristic findings in images of extra-pancreatic lesions associated with autoimmune pancreatitis. Eur J Radiol 76(2):228–238. doi:10.1016/j.ejrad.2009.06.010

Reddy S, Edil BH, Cameron JL et al (2008) Pancreatic resection of isolated metastases from nonpancreatic primary cancers. Ann Surg Oncol 15(11):3199–3206. doi:10.1245/s10434-008-0140-7

Inoue D, Gabata T, Matsui O, Zen Y, Minato H (2006) Autoimmune pancreatitis with multifocal mass lesions. Radiat Med 24(8):587–591. doi:10.1007/s11604-006-0071-9

Ueda K, Nagayama Y, Narita K, Kusano M, Mernyei M, Kamiya M (2000) Pancreatic involvement by non-Hodgkin’s lymphoma. J Hepatobiliary Pancreat Surg 7(6):610–613. doi:10.1007/s005340050243

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Insights into Imaging

Tập 4

321-329

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