[Peritoneal tuberculosis mimicking advanced ovarian carcinoma: distinction based on CT findings]

To evaluate the computed tomography (CT) findings of peritoneal tuberculosis mimicking advanced ovarian carcinoma for better understanding of the CT manifestations and accurate preoperative diagnosis.

CT findings of 18 cases with tuberculous peritonitis clinically simulating advanced ovarian cancer but pathologically proved otherwise were retrospectively reviewed.

1. Masses with solid and cystic structures were found in 6 cases and tumor-like flakes were found in 7 cases in the adnexal regions. The solid components and tumor-like flakes were moderately to markedly enhanced with dynamic CT scanning. 2. The peritoneum was smooth and slightly thickened in 10 cases; irregular thickening was seen in 4 cases, and patches of calcification in 3 cases. Thickened peritoneum with pronounced enhancement was noted in 7 cases. 3. Omentum with flake-like thickening was noted in 11 cases, coarse reticulate thickening in 2 cases and omental cakes in 2 cases. The margin of the thickened omentum with enhancement was ill-defined. 4. Nodular and stripe-like thickening of the mesentery was noted in 16 cases. 5. Ascites was present in all of the 18 cases, being encapsulated in 14 of them. 6. Lymphadenopathy was seen in 9 cases, all at located in the diaphragmatic levels. Enhancement of the lymph nodes was marked in 8 of the 8 patients examined. They appeared as ring-like (> 1 cm in diameter) or uniform (

CT examination combined with clinical manifestations helps differentiate tuberculous peritonitis from advanced ovarian cancer.