Primary Pancreatic Lymphoma with Active Gastric Bleeding. A Clinical Case and Review Literature.

Introduction: Primary pancreatic lymphoma is a rare clinical entity representing <0.5% of pancreatic cancers and 1% of extranodal lymphomas. Due to the lack of evidence of cases in the literature, their clinicopathological features, differential diagnosis, optimal therapy, and outcomes should be better defined. We will present a case of a 41-year-old woman who presented symptoms such as nausea, epigastric pain, red blood vomiting, and melena.  At laparotomy, a large necrotic mass was found in the body and tail of the pancreas, infiltrating the stomach and spleen. A biopsy of the mass confirmed large B-cell lymphoma. The patient was diagnosed and started chemotherapy. Conclusion: Primary pancreatic lymphoma is a rare clinical entity often misdiagnosed as pancreatic adenocarcinoma on presentation. Its clinical manifestations, radiological features, and biochemical signs are usually non-specific. It is based on a precise diagnosis made possible by histologic examination. Combined therapy remains the most optimal treatment approach for PPL but needs further evaluation.