gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLCgastro-j-1968Research ArticleНАЦИОНАЛЬНАЯ ШКОЛА ГАСТРОЭНТЕРОЛОГОВ, ГЕПАТОЛОГОВNATIONAL COLLEGE OF GASTROENTEROLOGISTS, HEPATOLOGISTSПервичная панкреатическая лимфомаPrimary pancreatic lymphomaМаевИ. В.MayevI. V.ТрухмановА. С.TrukhmanovA. S.ДоронинВ. А.DoroninV. A.КучерявыйЮ. А.KucheryavyYu. A.2008240620081834861Copyright © Маев И.В., Трухманов А.С., Доронин В.А., Кучерявый Ю.А., 20082008Маев И.В., Трухманов А.С., Доронин В.А., Кучерявый Ю.А.Mayev I.V., Trukhmanov A.S., Doronin V.A., Kucheryavy Y.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/1968

Цель обзора. Представить данные по эпидемиологии, этиологии и патогенезу, диагностике и лечению редкой разновидности лимфомы – первичной панкреатической лимфоме.Последние данные литературы. Лимфо­цитар­ные лимфомы (неходжкинские лимфомы) имеют лимфоретикулярное происхождение и включают большое количество типов, отличающихся по клеточному происхождению, клинике, локализации и распространенности, реакции на лечение. Внеузловые неходжкинские лимфомы встречаются с частотой, достигающей 30–40% от всех случаев лимфоцитарных лимфом, при этом опухолевое поражение органов желудочно­кишечного тракта регистрируется примерно в половине таких наблюдений. Среди органов пищеварения наиболее часто поражаются желудок и тонкая кишка. Поражение поджелудочной железы (ПЖ) может быть как изолированным (первичным), так и за счет опухолевой инфильтрации, распространяющейся со стороны смежных, вовлеченных в опухолевый процесс органов, а также лимфатических узлов. Клинические симптомы, данные лабораторно­инструментального исследования при первичной панкреатической лимфоме (ППЛ) неспецифичны. Диагностика базируется на морфологическом исследовании костного мозга и опухолевой ткани. Особые трудности отмечаются при разграничении с раком ПЖ. Своевременное обнаружение ППЛ дает возможность избежать чрезвычайно инвазивного оперативного лечения, поскольку опухоль высокочувствительна к химиотерапии.Заключение. Первичные панкреатические лимфомы составляют всего 0,5–0,9% от всех опухолей ПЖ и, как правило, представляют собой объемное образование, которое следует дифференцировать с раком ПЖ. Ранняя их диагностика позволяет прибегнуть к химиотерапии с хорошим прогнозом.

Aim of the review

Aim of the review. To present data on epidemiology, etiology and pathogenesis, diagnostics and treatment of rare type of lymphoma: primary lymphoma of the pancreas.

The recent literature data. Lymphocytic lymphomas (non-Hodgkin's lymphomas) have lymphoreticular origin and include plenty of types distinguished by cellular origin, clinical presentation, localization and prevalence, response to treatment. Extranodular nonHodgkin's lymphomas have frequency of 30 to 40% of all lymphocytic lymphomas cases, gastro-intestinal neoplasms are diagnosed approximately in half of these cases. The stomach and small intestine are the most frequently affected of digestive organs. Lesion of the pancreas can be both solitary (primary), and due to neoplastic infiltration from adjacent organs involved in neoplastic process, as well as from the lymph nodes. Clinical signs, data of laboratory and instrumental investigation at primary pancreatic lymphoma (PPL) are nonspecific. Diagnostics is based on morphological study of bone marrow and neoplastic tissue. The special difficulties occur at differentiation with pancreatic cancer. Well-timed detection of PPL helps to avoid extremely invasive surgery as the tumor is highly sensitive to chemotherapy.

Conclusion

Conclusion. Primary pancreatic lymphomas are responsible for only 0,5–0,9% of all pancreatic tumors and, as a rule, present themselves as a focal lesion which should be differentiated with pancreatic cancer. Their early diagnostics allows to resort to chemotherapy with favorable prognosis.

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The authors declare that there are no conflicts of interest present.