Diffuse large B-cell pancreatic lymphoma diagnosed with EUS-FNA in a patient with Roux-en-Y gastric bypass anatomy

Abstract Text A 29-year-old woman with a surgical history of Roux-en-Y gastric bypass (RYGB) for morbid obesity presented with obstructive jaundice and pancreatitis. All etiologies were excluded. Ca19.9 was 82.8 U/mL. CT-scan and EUS from the stomach showed a diffusely enlargement of pancreas with inhomogeneous echogenicity, without focal lesion, and splenomegaly. FNAB of the body was then performed with a 22G needle. Cytomorphology was suggestive of a lymphoproliferative disorder. Immunohistochemistry on cytology cell block showed atypical lymphoid cells positive for LCA, CD20, BCL6, and MUM1, and negative for CD10, with Ki67 positive tumor cells up to 90%. This pattern was consistent with a non-Hodgkin’s lymphoma.