PMC5857486_01
(a) Fat-suppressed T2-weighted MR image shows a bulky circumscribed homogeneously hyperintense mass in the pancreatic head (red arrow) and (b) Fat-suppressed T1-weighted MR image shows a hypointense mass in the pancreatic head (red arrow) relative to adjoining normal pancreatic parenchyma.
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Gadolinium-enhanced dynamic MRI examination with arterial, venous and delayed phase fat-saturated T1-weighted images demonstrated a bulky circumscribed poorly enhanced mass in the pancreatic head with normally enhanced adjacent pancreatic parenchyma (Fig. 1a and b).
Hematoxylin-eosin-stained histologic section (magnification x 400) revealed a diffuse growth pattern and atypical large lymphocytes without follicular structures.
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Excisional biopsy of an enlarged left superficial inguinal lymph node revealed a diffuse growth pattern and large lymphocytes without follicular structures (Fig. 2).
Fine-needle aspiration cytology is consistent with B-cell lymphoma. High power view (x40) shows numerous large monotonous lymphocytes with open chromatin admixed with small, dark, round, mature lymphocytes.
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Hematoxylin and eosin staining of tissue specimens showed that tumor cells were medium sized atypical lymphocytes with diffuse proliferation and without follicular structures (Fig. 3).