Primary lymphoma of the ampulla of vater

Pawade, Joya; Lee, Soon C.; Ellis, David W.; Vellar, Ivo D.; Rode, J.

doi:10.1002/1097-0142(19940415)73:8<2083::aid-cncr2820730812>3.0.co;2-b

Cited by 26 publications

(10 citation statements)

References 22 publications

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“…An NHL mass, too small to be detected by CT or US, infi ltrating the ampulla of Vater is an extremely rare cause of obstructive jaundice, and we found only three other cases reported. [6][7][8] The histological types were large cell lymphoma, 6 mucosa-assisted lymphoid tissue lymphoma, 7 and T-cell lymphoma, 8 respectively, whereas it was diffuse large B-cell lymphoma, predominantly infi ltrating the ampulla of Vater, in our patient. The mass also infi ltrated the peripheral duodenal wall (which caused narrowing of the second portion of the duodenum), the posterior pancreatico-duodenal lymph nodes, and skipped into the jejunal mesenteric lymph nodes.…”

Section: Discussionmentioning

confidence: 89%

Diffuse Large B-cell Lymphoma in the Ampulla of Vater Causing Obstructive Jaundice: Report of a Case

et al. 2007

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We report a case of diffuse large B-cell lymphoma (DLBCL) in the ampulla of Vater, causing painless obstructive jaundice in a 78-year-old woman. Duodenal endoscopy revealed a mass in the ampulla of Vater and narrowing of the second portion of the duodenum, although diagnosing DLBCL from an endoscopic biopsy was impossible because there were several kinds of leukocytes in the infiltrate. We performed pylorus-preserving pancreatoduodenectomy to establish a histological diagnosis, relieve the obstructive jaundice, and remove the narrowed second portion of the duodenum. Histological and immunohistochemical examination of the surgically resected specimen confirmed a diagnosis of DLBCL. Chemotherapy is the mainstay of treatment for DLBCL; however, surgery still plays an important role when the histological diagnosis cannot be established preoperatively and when complications are not amenable to nonsurgical therapy.

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Section: Discussionmentioning

confidence: 89%

Diffuse Large B-cell Lymphoma in the Ampulla of Vater Causing Obstructive Jaundice: Report of a Case

et al. 2007

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“…Obstruction of the extrahepatic bile duct by lymphoma can take various forms, including primary NHL arising from the extrahepatic bile duct [7,[23][24][25][26], primary involvement of the CBD by HD [8], compression of the extrahepatic bile duct by enlarged lymph nodes [1, 3-6, 14, 22], primary lymphoma arising from the porta hepatis [9,27,28], primary lymphoma of the ampulla of Vater [10], primary lymphoma of the pancreas involving the CBD by direct extension [11], gastrointestinal lymphoma obstructing the bile duct at the ampulla of Vater [12,16,29], and radiation-induced biliary stricture [13].…”

Section: Discussionmentioning

confidence: 99%

“…Biliary obstruction has been reported more often in the peripancreatic area than in the hepatic hilum. Of 42 previously reported patients, 27 had lesions in the peripancreatic area, as follows: 16 had lymphoma-related masses [3,4,6,14,[30][31][32], 8 had gastrointestinal lymphoma [4,12,16,29,[33][34][35], 2 had primary pancreatic lymphoma [4,36], and 1 had primary lymphoma of the ampulla of Vater [10]. The other 15 patients had lesions at the hilum: 12 had lymphoma-related masses [2,3,6,14,31] and 3 had primary porta hepatis lymphoma [9,27,28].…”

Section: Discussionmentioning

confidence: 99%

“…Jaundice that occurs with lymphoma can result from many causes, but the most common cause is tumor-related compression of the biliary tract [3][4][5][6]. Lymphoma can affect the biliary tract by various mechanisms [4,[7][8][9][10][11][12][13] and, on cholangiography, may resemble other causes of obstructive jaundice that are more common [1,2,14]. Chemotherapy with or without radiotherapy is the mainstay of treatment for lymphoma, but whether patients with extrahepatic biliary obstruction need biliary drainage remains controversial.…”

Section: Introductionmentioning

confidence: 99%

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Biliary Tract Obstruction Secondary to Malignant Lymphoma: Experience at a Referral Center

et al. 2007

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Lymphoma is a rare cause of biliary obstruction and, on cholangiography, may mimic other causes of obstructive jaundice. The optimum treatment for these patients is unclear. The aim of this study is to evaluate the incidence, clinical and imaging findings, management, and outcome of biliary obstruction caused by lymphoma. Our database was searched retrospectively for patients with biliary obstruction due to lymphoma between 1999 and 2005. Biliary obstruction secondary to lymphoma was found in 7 (0.6%) of 1123 patients with malignant biliary obstruction. One patient had benign biliary obstruction related to lymphoma. Of the eight patients (five male, three female; mean age, 34.50 +/- 17.93 years), four had Hodgkin's disease and four had non-Hodgkin's lymphoma. Biliary obstruction occurred as part of the initial or early presentation of lymphoma in two patients. The most common cause of obstruction was compression of the biliary tract by enlarged lymph nodes (six patients). Cholangiographic appearances were diverse: narrowing of the common bile duct (six patients), splayed and narrowed common bile duct (one patient), and multiple strictures and dilatations of the intrahepatic bile ducts (one patient). Biliary drainage was performed in all patients including endoscopic stent placement in six patients, nasobiliary drainage in one, and choledochoduodenostomy in one. Hyperbilirubinemia resolved in all but one of the patients with a stent; however, none could be maintained in a stent-free condition. Five patients died within 1 year after onset of jaundice. One of the surviving patients developed a late benign stricture at the site of the earlier lymphoma. We conclude that lymphoma should be considered in the differential diagnosis of obstructive jaundice, particularly in younger patients. We suggest that biliary drainage by the endoscopic or percutaneous route is necessary for the treatment of these patients. Late benign strictures may develop. Biliary obstruction is a sign of poor prognosis in lymphoma.

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“…Endoscopically, whitish elevated lesions were observed in three patients, one of which indicated giant rugae, while erosions or ulcers werefoundin" three cases. Interestingly, obstructive jaundice was observed in two cases of primary non-Hodgkin's lymphoma and follicle center lymphoma of the ampulla of Vater, reported by Pawade et al (15) and Misdraji et al (16), respectively. In these cases, the tumors were curatively resected using Whipple's procedure even though the tumor infiltration of the sphincter of Oddi and the head of the pancreas was recognized.…”

Section: Case Reportmentioning

confidence: 99%

Primary Duodenal MALT Lymphoma.

et al. 1999

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Primary duodenal MALTlymphoma(MALToma) is a very rare neoplasm arising from the mucosa-associated lymphoid tissue of the duodenum.Wereport a 55-year-old womanwith MALTomalocated in the descending duodenum and accompanying Helicobacterpylori infection of the stomach. Weperformed operative resection due to involvement of the papilla of Vater and submucosal tumor infiltration. Despite wide mucosal spreading, postoperative examination revealed only a small amount of MALToma cells infiltrating into the submucosa. No invasion into the adjacent structure or metastasis to regional lymphnodes was confirmed, suggesting the disease could have been controlled by eradication of Helicobacter pylori. (Internal Medicine 38: 957-961, 1999)

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Primary lymphoma of the ampulla of vater

Cited by 26 publications

References 22 publications

Diffuse Large B-cell Lymphoma in the Ampulla of Vater Causing Obstructive Jaundice: Report of a Case

Diffuse Large B-cell Lymphoma in the Ampulla of Vater Causing Obstructive Jaundice: Report of a Case

Biliary Tract Obstruction Secondary to Malignant Lymphoma: Experience at a Referral Center

Primary Duodenal MALT Lymphoma.

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