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Lymphoma presenting as peritoneal lymphomatosis with ascites
1Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
Journal of the Chinese Medical Association : JCMA
|December 31, 2008
Summary
Disseminated peritoneal lymphoma, though rare, requires prompt diagnosis. This case highlights ascites cytology as an effective method for identifying diffuse large B-cell lymphoma, crucial for timely patient management.
Area of Science:
- Oncology
- Hematology
- Pathology
Background:
- Peritoneal carcinomatosis is more clinically recognized than disseminated peritoneal lymphoma.
- Disseminated peritoneal lymphoma is a rare condition involving intra-abdominal organ infiltration.
Observation:
- An 89-year-old female presented with disseminated peritoneal lymphoma involving gastric and rectal sites, accompanied by significant ascites.
- Ascitic fluid analysis revealed positive markers (CD19, CD20, CD45) via flow cytometry.
- Biopsies confirmed diffuse large B-cell lymphoma in the stomach and rectum.
Findings:
- Ascites cytology is a valuable, rapid diagnostic tool for peritoneal lymphomatosis.
- Diagnosis can be challenging due to overlapping clinical and imaging features with other conditions.
Implications:
- Early diagnosis of peritoneal lymphomatosis is essential for improving patient survival.
- Management strategies for peritoneal lymphomatosis should be individualized.
- Awareness of this rare entity is critical for accurate differential diagnosis.
