NonHodgkin's Lymphoma with Peritoneal Localization
E Curakova1, M Genadieva-Dimitrova1, J Misevski1
1University Clinic of Gastroenterohepatology, Medical Faculty, Ss. Cyril and Methodius University, Mother Teresa 17, 1000 Skopje, Macedonia.
Case Reports in Gastrointestinal Medicine
|April 9, 2014
Summary
Diffuse large B-cell lymphoma rarely involves the peritoneum. This case highlights that peritoneal lymphomatosis diagnosis, even with negative cytology, requires surgical laparoscopy and biopsy for definitive confirmation.
Area of Science:
- Oncology
- Pathology
- Gastroenterology
Background:
- The gastrointestinal tract is the most common extranodal site for lymphoma (5-20% of cases).
- Diffuse peritoneal and omental infiltration by lymphoma is exceptionally rare.
- This presentation mimics other conditions causing ascites and pleural effusion.
Purpose of the Study:
- To report a rare case of diffuse large B-cell lymphoma involving the peritoneum.
- To emphasize the diagnostic challenges in peritoneal lymphomatosis.
- To highlight the importance of surgical laparoscopy and biopsy for definitive diagnosis.
Main Methods:
- Case report of a 57-year-old female with unexplained ascites and pleural effusion.
- Initial examinations included imaging, blood count, and cytology of effusions.
- Postmortem diagnosis confirmed via histological and immunohistochemical examination of peritoneal and omental tissue obtained during laparoscopy.
Main Results:
- No digestive tract or parenchymal organ pathology found on initial examination.
- Peritoneal and omental thickening was the primary finding.
- Ascitic and pleural fluid cytology were negative for malignant cells.
- Diagnosis of diffuse large B-cell lymphoma was confirmed postmortem.
Conclusions:
- Peritoneal lymphomatosis is a rare manifestation of lymphoma.
- Negative cytology does not exclude peritoneal lymphomatosis.
- Surgical laparoscopy with peritoneal biopsy is crucial for definitive diagnosis in suspected cases.
