Sia SY, Kapur J, Thian YL
Correspondence: Dr David Soon Yiew Sia, davidssy@yahoo.com
ABSTRACT
Peritoneal lymphomatosis, a rare presentation of lymphoma, can mimic peritoneal carcinomatosis. Computed tomography findings in both conditions include omental caking, as well as peritoneal enhancement, thickening and nodularity. We report three cases of peritoneal lymphomatosis and give an analysis of the salient imaging features that aided in the accurate diagnosis of the condition in each case. Two of the three cases demonstrated elevated serum cancer antigen 125 levels, a marker commonly associated with ovarian carcinoma. It is thus critical to distinguish peritoneal lymphomatosis from carcinomatosis, as the prognosis and management are dramatically different.
Keywords: CA 125, computed tomography, magnetic resonance imaging, peritoneal lymphomatosis, uterine lymphoma
Singapore Med J 2013; 54: e93-e96; http://dx.doi.org/10.11622/smedj.2013091
REFERENCES
1. Thomas AG, Vaidhyanath R, Kirke R, Rajesh A. Extranodal lymphoma from head to toe: part 2, the trunk and extremities. AJR Am J Roentgenol 2011; 197:357-64. http://dx.doi.org/10.2214/AJR.11.6738 | ||||
2. Garrison RN, Kaelin LD, Galloway RH, Heuser LS. Malignant ascites. Clinical and experimental observations. Ann Surg 1986; 203:644-51. http://dx.doi.org/10.1097/00000658-198606000-00009 | ||||
3. Lynch MA, Cho KC, Jeffrey RB Jr, Alterman DD, Federle MP. CT of peritoneal lymphomatosis. AJR Am J Roentgenol 1988; 151:713-5. http://dx.doi.org/10.2214/ajr.151.4.713 | ||||
4. Simonelli C, Spina M, Cinelli R, et al. Clinical features and outcome of primary effusion lymphoma in HIV-infected patients: a single-institution study. J Clin Oncol 2003; 21:3948-54. http://dx.doi.org/10.1200/JCO.2003.06.013 | ||||
5. Karaosmanoglu D, Karcaaltincaba M, Oguz B, et al. CT findings of lymphoma with peritoneal, omental and mesenteric involvement: peritoneal lymphomatosis. Eur J Radiol 2009; 71:313-7. http://dx.doi.org/10.1016/j.ejrad.2008.04.012 | ||||
6. Kim Y, Cho O, Song S, et al. Peritoneal lymphomatosis: CT findings. Abdom Imaging 1998; 23:87-90. http://dx.doi.org/10.1007/s002619900292 | ||||
7. Horger M, Müller-Schimpfle M, Yirkin I, Wehrmann M, Claussen CD. Extensive peritoneal and omental lymphomatosis with raised CA 125 mimicking carcinomatosis: CT and intraoperative findings. Br J Radiol 2004; 77:71-3. http://dx.doi.org/10.1259/bjr/35139284 | ||||
8. Kim YG, Baek JY, Kim SY, et al. Peritoneal lymphomatosis confounded by prior history of colon cancer: a case report. BMC Cancer 2011; 11:276. http://dx.doi.org/10.1186/1471-2407-11-276 | ||||
9. Kim YS, Koh BH, Cho OK, Rhim HC. MR imaging of primary uterine lymphoma. Abdom Imaging 1997; 22:441-4. http://dx.doi.org/10.1007/s002619900229 | ||||
10.Kawakami S, Togashi K, Kojima N, et al. MR appearance of malignant lymphoma of the uterus. J Comput Assist Tomogr 1995; 19:238-42. http://dx.doi.org/10.1097/00004728-199503000-00014 | ||||
11. Suzuki Y, Tamaki Y, Hasegawa M, Maebayashi K, Mitsuhashi N. Magnetic resonance images of primary malignant lymphoma of the uterine body: a case report. Jpn J Clin Oncol 2000; 30:519-21. http://dx.doi.org/10.1093/jjco/hyd125 | ||||
12. Urban BA, Fishman EK. Renal lymphoma: CT patterns with emphasis on helical CT. Radiographics 2000; 20:197-212. | ||||
13. Lee WK, Lau EW, Duddalwar VA, Stanley AJ, Ho YY. Abdominal manifestations of extranodal lymphoma: spectrum of imaging findings. AJR Am J Roentgenol 2008; 191:198-206. http://dx.doi.org/10.2214/AJR.07.3146 | ||||
14.Cardona DM, Layne A, Lagoo AS. Lymphomas of the gastro-intestinal tract- pathophysiology, pathology, and differential diagnosis. Indian J Pathol Microbiol 2012; 55:1-16. http://dx.doi.org/10.4103/0377-4929.94847 PMid:22499293 | ||||
15. Leite NP, Kased N, Hanna RF, et al. Cross-sectional imaging of extranodal involvement in abdominopelvic lymphoproliferative malignancies. Radiographics 2007; 27:1613-34. http://dx.doi.org/10.1148/rg.276065170 | ||||
Abd El Gawad IA, Shafik HE. CA 125, a new prognostic marker for aggressive NHL. J Egypt Natl Canc Inst 2009; 21:209-17. PMid:21132031 | ||||