Rare case of pancreatic Hodgkin lymphoma is often misdiagnosed as pancreatic adenocarcinoma

A new case report was published in Volume 12 of Oncoscience on October 6, 2025, titled "A peculiar case of primary lymphoma of pancreas: A rare presentation of Hodgkin lymphoma."

In this report led by first author Osama Mohiuddin from Ascension At Agnes Healthcare, with corresponding author Rafi Aibani from Charleston Area Medical Center, researchers describe a rare medical case in which Hodgkin lymphoma is presented as a pancreatic mass. The findings emphasize how easily this type of cancer can be misdiagnosed, potentially delaying effective treatment.

Hodgkin lymphoma is a type of blood cancer that typically affects the lymphatic system and usually appears in lymph nodes. Its appearance in the pancreas is exceptionally rare. This case involved a 50-year-old man who experienced low-grade fever, abdominal pain, and significant unintentional weight loss, symptoms frequently linked to pancreatic cancer. Imaging showed a sizable mass in the pancreas, initially raising concern for pancreatic adenocarcinoma, the most common type of pancreatic cancer.

"Primary pancreatic Hodgkin lymphoma (PPL) is an exceptionally rare condition often misdiagnosed as pancreatic adenocarcinoma or pseudocyst."

A lymph node biopsy revealed that the patient had a nodular sclerosis subtype of Hodgkin lymphoma. This result was confirmed through staining techniques. The diagnosis shifted the treatment plan from potential surgery or radiation toward chemotherapy specifically designed for Hodgkin lymphoma. The patient began a targeted regimen known as A+AVD.

This rare presentation highlights the challenges clinicians face when diagnosing pancreatic tumors. Primary pancreatic lymphoma accounts for less than 1% of all pancreatic cancers, and Hodgkin lymphoma is even more uncommon in this location. Because the clinical signs and imaging findings often resemble pancreatic cancer, a biopsy is essential to ensure the correct diagnosis.

The case also illustrates the limitations of imaging alone. Unlike pancreatic adenocarcinomas, lymphomas typically do not cause tissue death, calcification, or obstruction of pancreatic ducts. These differences, when combined with biopsy results, can guide toward more accurate diagnoses.

As treatments for Hodgkin lymphoma continue to improve, especially with drugs like brentuximab vedotin, early diagnosis becomes critical. This case report is a reminder that not all pancreatic tumors are what they appear to be. In rare cases, they may reflect a treatable cancer that responds well to targeted therapy if diagnosed in time.