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Updated: Jan 28, 2026

Invasive Hemodynamic Characterization of the Portal-hypertensive Syndrome in Cirrhotic Rats
Published on: August 1, 2018
Peritoneal lymphoma with ascites mimicking portal hypertensive ascites: A case report
En-Shao Liu1, Jyh-Seng Wang2, Wen-Chi Yang3,4
1Department of Internal Medicine.
Rationale:
Lymphoma with an initial manifestation of ascites and peritoneal invasion is rare.
Patient Concerns:
A 65-year-old woman presented to the emergency department with a 3-week history of abdominal distention, anorexia, and night sweating, and a 2-week history of melena. She was a silent hepatitis B virus carrier. Abdominal ultrasound showed massive ascites without cirrhosis. Abdominal computed tomography revealed ascites, infiltrative peritoneal lesions with omental cake appearance, and lymphadenopathies.
Diagnosis:
We performed paracentesis and the ascites cytology was obtained. The patient also underwent esophagogastroduodenoscopy, which showed ulcerative tumors in the stomach. Both ascites cytology and pathology of the gastric tumors confirmed the diagnosis of B-cell lymphoma.
Interventions:
This patient received 7 cycles of chemotherapy.
Outcomes:
Follow-up imaging studies revealed partial remission of lymphoma, but an enlargement of residual tumors in omentum and mesentery, which resulted in intractable ascites and rapid deterioration of performance status. Despite a change of regimen of chemotherapy, this patient expired 10 months after diagnosis.
Lessons:
Lymphoma should be one of the differential diagnoses in patients with intractable ascites not attributable to other comorbidities.
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