Synchronous Hodgkin's lymphoma and periampullary carcinoma: An unusual association

Abstract

Carcinomas arising within 2.0 cm of major duodenal papilla are called periampullary carcinomas. These include carcinomas of the ampulla, distal common bile duct, pancreas, and duodenum. Hodgkin's lymphoma is a malignant neoplasm of lymphoreticular cell origin characterized by the presence of Hodgkin's and Reed–Sternberg cells. We report the case of a 58-year-old male with a 9-month history of abdominal pain, nausea, and vomiting with jaundice and itching all over the body for the past 4 months along with generalized lymphadenopathy and fever for the past 7 months. On ultrasonography, a periampullary mass of size 6.6 cm × 3.5 cm was noted. On computed tomography, an ill-defined soft-tissue mass measuring 7 cm × 3.5 cm × 1.8 cm was seen in the periampullary region with marked dilatation of common bile duct and generalized lymphadenopathy. Fine-needle aspiration and biopsy from both the mass lesions were performed. The patient underwent the Whipple procedure. He was diagnosed with synchronous periampullary carcinoma of the pancreas with Hodgkin's lymphoma based on radiological and histopathological examination of resected mass and excisional biopsy of a lymph node.

Keywords

• hodgkin's lymphoma
• pancreatic carcinoma
• periampullary
• reed–sternberg cells