Table 1

Patient characteristics, treatment and outcomes

Case 1

Case 2

Case 3

Case 4


Age

64

70

56

61

Sex

Male

Male

Male

Male

Presenting Symptoms

Abdominal pain, nausea, weight loss then jaundice

Vomiting, weight loss

Dyspepsia, weight loss

Abdominal pain, weight loss then jaundice

Delay until diagnosis

5 weeks

3 months

18 months

4 months

Method of diagnosis

Endoscopic ultrasound FNA

Laparotomy

Laparotomy

Laparotomy

CT appearance

6 cm pancreatic mass with biliary obstruction and portal vein involvement

Large peri-pancreatic mass

5 cm pancreatic mass

Pancreatic mass and peripancreatic lymph nodes

Ca-19.9 level*

500 kU/L

50 kU/L

Not available

39 kU/L

Pre-treatment LDH

Normal

Elevated

Normal

Elevated

Histology**

DLBCL

DLBCL

Grade II follicular non-Hodgkins lymphoma

DLBCL

Stage***

IIE

IIE

IIE

IIE

Prognostic index

Low-intermediate risk (IPI 2/5)

Low-intermediate risk (IPI 2/5)

Low risk (FLIPI 1/5)

Low-intermediate risk (IPI 2/5)

Treatment

R-CHOP * 4 then involved-field RT

CHOP * 3 then involved-field RT

Involved-field RT then CVP then rituximab

3 * CHOP then involved-field RT

Outcome

NED at 23 months

Local recurrence at 32 months post-diagnosis, with poor tolerance of 2nd line chemotherapy and rapid treatment-related death

NED at 25 months

Out of field recurrence at 21 months post diagnosis. Salvage chemotherapy and autologous SCT. NED at 64 months from diagnosis


CHOP – Cyclophosphamide, doxorubicin, vincristine, prednisone

CVP – Cyclophosphamide, vincristine, prednisone

DLBCL – diffuse large B-cell non-Hodgkin's lymphoma

FLIPI – Follicular lymphoma international prognostic index [8]

IPI – International Prognostic Index for the Aggressive Non-Hodgkin's Lymphomas [7]

NED – No evidence of disease

R-CHOP – Rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone

RT – Radiotherapy

SCT – Stem cell transplantation

* Normal Range 0–50 kU/L

** Histology defined according to REAL classification.[5]

*** Staging defined according to Ann Arbor staging system.[4]

Grimison et al. BMC Cancer 2006 6:117   doi:10.1186/1471-2407-6-117

Open Data