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
|