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Facchinelli D, Sina S, Boninsegna E, Borin A, Tisi MC, Piazza F, Scapinello G, Maiolo E, Hohaus S, Zamò A, Merli M, Stefani PM, Mellone F, Basso M, Sartori R, Rusconi C, Parisi A, Manfrin E, Krampera M, Ruggeri M, Visco C, Tecchio C. Primary pancreatic lymphoma: Clinical presentation, diagnosis, treatment, and outcome. Eur J Haematol 2020; 105:468-475. [PMID: 32542880 DOI: 10.1111/ejh.13468] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 12/13/2022]
Abstract
Primary pancreatic lymphoma (PPL) is a rare disease representing 0.1% of malignant lymphomas, which lacks well-defined diagnostic and therapeutic protocols. OBJECTIVES To describe PPL clinical, diagnostic and histological characteristics, together with therapy and outcome, in a relatively large series of patients. METHODS The study includes 39 PPL patients, aged ≥15 years, observed from January 2005 to December 2018, in 8 Italian Institutions. RESULTS The main symptoms were abdominal pain (58%) and jaundice (47%). Lactate dehydrogenase serum levels were elevated in 43% of patients. Histological specimens were mostly obtained by percutaneous (41%) or endoscopic (36%) biopsy, with diffuse large B-cell lymphoma being the most frequent (69%) histological diagnosis. Chemotherapy was administered alone in 65% of patients, with radiotherapy in 17%, or after surgery in 9%. The 2-year overall survival (OS) was 62%, the 2-year progression-free survival (PFS) 44%. Debulking surgery (with or without chemotherapy) was associated with a significant worse OS. Three (9.4%) of 32 high-grade patients experienced a central nervous system (CNS) relapse. CONCLUSIONS PPL is rare, often high-grade, with symptoms and localization similar to other pancreatic malignancies. Biopsy should be the preferred diagnostic method. High-grade PPL should undergo CNS prophylaxis.
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Affiliation(s)
- Davide Facchinelli
- Hematology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Sokol Sina
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | - Alex Borin
- Unit of General and Pancreatic Surgery, Department of Surgery and Oncology, Pancreas Institute, University of Verona, Verona, Italy
| | - Maria C Tisi
- Hematology Unit, Ospedale San Bortolo, Vicenza, Italy
| | - Francesco Piazza
- Hematology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Greta Scapinello
- Hematology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Elena Maiolo
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Istituto di Ematologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Stefan Hohaus
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Istituto di Ematologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alberto Zamò
- Department of Oncology and Pathology Unit, AOU Città della Salute e della Scienza, Turin, Italy
| | - Michele Merli
- Division of Hematology, Ospedale di Circolo e Fondazione Macchi- ASST Sette Laghi, University of Insubria, Varese, Italy
| | | | - Federica Mellone
- Institute of Medical Statistics, University of Verona, Verona, Italy
| | - Marco Basso
- Hematology Unit, Ospedale di Castelfranco Veneto, Vicenza, Italy
| | - Roberto Sartori
- Hematology Unit, Ospedale di Castelfranco Veneto, Vicenza, Italy
| | - Chiara Rusconi
- Division of Hematology, ASST Niguarda Hospital, Milano, Italy
| | - Alice Parisi
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Erminia Manfrin
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Mauro Krampera
- Hematology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Marco Ruggeri
- Hematology Unit, Ospedale San Bortolo, Vicenza, Italy
| | - Carlo Visco
- Hematology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Cristina Tecchio
- Hematology Unit, Department of Medicine, University of Verona, Verona, Italy
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