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World J Gastroenterol. Nov 21, 2008; 14(43): 6738-6742
Published online Nov 21, 2008. doi: 10.3748/wjg.14.6738
Value of ultrasound examination in differential diagnosis of pancreatic lymphoma and pancreatic cancer
Li Qiu, Yan Luo, Yu-Lan Peng
Li Qiu, Yan Luo, Yu-Lan Peng, Department of Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Qiu L and Luo Y designed the research; Qiu L, Luo Y and Peng YL did the ultrasound examination; Qiu L and Peng YL collected the data; Qiu L and Luo Y drafted and revised the manuscript and approved the final version.
Correspondence to: Li Qiu, Department of Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China. wsqiuli@126.com
Telephone: +86-28-85422304 Fax: +86-28-85423192
Received: September 4, 2008
Revised: October 13, 2008
Accepted: October 20, 2008
Published online: November 21, 2008
Abstract

AIM: To investigate the value of clinical manifestations and ultrasound examination in the differential diagnosis of pancreatic lymphoma and pancreatic cancer.

METHODS: The clinical and ultrasonic characteristics of 12 cases of pancreatic lymphoma and 30 cases of pancreatic cancer were retrospectively analyzed.

RESULTS: Statistically significant differences were found in the course of disease, back pain, jaundice, carcino-embryonic antigen (CEA) and CA19-9 increase, palpable abdominal lump, superficial lymph node enlargement, fever and night sweats, lesion size, bile duct expansion, pancreatic duct expansion, vascular involvement, retroperitoneal (below the renal vein level) lymph node enlargement, and intrahepatic metastasis between pancreatic lymphoma and pancreatic cancer. There were no significant differences in age of onset, gender ratio, weight loss, nausea and vomiting, lesion position, the echo of the lesion, and the blood flow of the lesion.

CONCLUSION: Pancreatic lymphoma should be considered for patients with long lasting symptoms, superficial lymph node enlargement, palpable abdominal lump, fever and night sweats, relatively large lesions, and retroperitoneal (below the level of the renal vein) lymph node enlargement. A diagnosis of pancreatic cancer should be considered more likely in the patients with relatively short disease course, jaundice, back pain, CEA and CA19-9 increase, relatively small lesions, bile duct expansion, obvious pancreatic duct expansion, peripheral vascular wrapping and involvement, or intrahepatic metastases.

Keywords: Ultrasound; Pancreatic lymphoma; Pancreatic cancer