Primary pancreatic lymphoma (PPL) is a rare condition often confused and diagnosed as a pancreatic malignancy due to the similarity in clinical presentations of the two entities. Patients of PPL may present with features of obstructive jaundice. Here, we discuss the case of a 27-year-old male who presented to the hospital with features of obstructive jaundice, cholangitis, swelling over the scalp, and right scapular region. The patient was diagnosed to have a pancreatic head mass with radiological investigations. Endoscopic ultrasonography (EUS)-guided fine-needle aspiration cytology report was inconclusive, and the final diagnosis of PPL was made after a cervical lymph node biopsy. The patient received treatment with rituximab, doxorubicin, cyclophosphamide, vincristine, and prednisolone regimen and went into remission.

Obstructive jaundice due to pancreatic stone is very rare. We report a case of obstructive jaundice in a patient with chronic pancreatitis, occurring due to the pancreatic stone getting impacted at the ampulla and subsequently, leading to gallbladder perforation, without any dilatation of the biliary tree. This could be explained due to the lower insertion of the cystic duct. Such instances can be managed with percutaneous tube cholecystostomy, endoscopic retrograde cholangiopancreatography, pancreatic stone extraction, and stenting of both the main pancreatic duct and the common bile duct.