An 82-year-old man was admitted to hospital with symptoms of abdominal fullness and loss of appetite. Abdominal computed tomography (CT) scan and ultrasonography showed enlargement of the whole pancreas with para-aortic lymphadenopathy. Endoscopic retrograde pancreatography (ERP) showed diffuse narrowing of the main pancreatic duct (MPD), and brushing cytology from the MPD was non-neoplastic. Differential diagnosis between lymphoma and other exocrine and endocrine pancreatic malignancies was needed, and the level of serum soluble interleukin-2 receptor (17 751 U/ml) was revealed to be significantly high, which was strongly suggestive of pancreatic lymphoma. Chemotherapy was refused by the patient's family and the patient succumbed after 2 months of conservative follow-up. Autopsy revealed diffuse, mixed cell-type, non-Hodgkin's lymphoma of T-cell subtype.