A Patient with Chronic Hepatitis C and a Pancreatic Mass in Endoscopic Ultrasound

Abstract

We report a rare case of pancreas tumor (lymphoma) in a patient with a history of chronic hepatitis C virus (HCV) infection without treatment, with a high viral load (20,199,805 IU/ml). He presented with abdominal pain, jaundice, weight loss and sweating. Computed tomography showed a hypodense mass located in the head of the pancreas, and immunohistochemistry of a specimen obtained by endoscopic ultrasound-guided fine needle aspiration revealed non-Hodgkin’s lymphoma of the pancreas, B cell type. An association of HCV infection with pancreatic lymphoma has only been reported rarely in the literature and its clinical significance is uncertain.

Pancreatic lymphoma complicating early stage chronic hepatitis C

“…Takagi et al 5 and Ghobakhlou et al 1 also showed cases of patients with CHC who developed a pancreatic malignancy. One study by Huang et al showed that with 340 819 person-years in the HCV cohort, 34 pancreatic cancers were identified.…”

“…Chronic HCV infection has been associated with many extrahepatic manifestations including the development of B-cell non-Hodgkin's lymphoma (NHL). Primary pancreatic lymphoma is very rare and comprises 2.2% of NHL and 4.9% of all pancreatic malignancies 1. We report a patient with early stage HCV infection who developed and died of complications from a primary pancreatic lymphoma.…”

Primary Pancreatic Malignant Lymphoma Diagnosed from Endoscopic Ultrasound-guided Fine-needle Aspiration Findings

“…With the exception of the male predominance, these trends were consistent with the characteristics of the present case. On the other hand, anti-HCV antibody was detected in our patient and she was considered to be in a post-infection state of hepatitis C. There are several reports of patients with malignant lymphoma and a history of HCV infection (5,6), and the tropism of the lymphoid tissue, which occurs in HCV, has been suggested to be responsible for several immune-mediated disorders such as mixed cryoglobulinemia (7). At the present time, however, there is no accepted evidence to show that HCV induces the carcinogenesis of B-cells.…”

Primary hepatopancreatobiliary lymphoma: Pathogenesis, diagnosis, and management

“…It is commonly associated with immunosuppression, related to HIV infection or solid organ transplantation ( 139 ). A few studies have implied that HCV or HBV infection is associated with PPL ( 140 , 141 ).…”