Abstract
Peritoneal lymphomatosis is extremely rare and associated with poor prognosis. Most practitioners only pay more attention to peritoneal carcinomatosis. However, peritoneal lymphomatosis can be neglected and misdiagnosed. We report a teenager with 10 days of abdominal distension and pain accompanied by computed tomography scan suggesting diffuse thickening of the peritoneum and omentum and abdominopelvic effusion. Tuberculous peritonitis and peritoneal carcinomatosis were initially suspected. However, it was finally confirmed as non-Hodgkin’s B-cell lymphoma by omentum biopsies. He achieved complete remission after chemotherapy and autologous stem cell transplantation. But unfortunately, he suffered a relapse and died 10 months after diagnosis. Following a review of the literature, it can be concluded that the discovery of lymphomatosis in peritoneum is a rare finding. Lymphoma should be considered in the differential diagnosis of unexplained peritoneal thickening on computed tomography, and this case emphasizes the importance of early pathological diagnosis to make sure that the right treatment can be started opportunely.
Highlights
Non-Hodgkin’s lymphoma (NHL) includes more than 90 distinct genotypes of hematologic malignancies
The youngest case reported until now was a 3-year-old infant [14]. This is the first report of isolated peritoneal lymphomatosis with diffuse large B-cell lymphoma (DLBCL) in a teenager
Most peritoneal lymphomatosis (PL) patients predominantly complain of abdominal pain, distension, and weight loss [5, 8, 11], though these clinical manifestations are non-specific
Summary
Non-Hodgkin’s lymphoma (NHL) includes more than 90 distinct genotypes of hematologic malignancies. A 16-year-old boy was admitted to our hospital with a 10-day history of abdominal distension and epigastric pain, accompanied by anorexia, nausea, vomiting, dyspnea, palpitations, as well as low fever and night sweating He had always been in good health with no significant medical or malignant family history. Immunohistochemical stain subsequently showed positivity for CD10, CD20, PAX-5, and c-myc with proliferative fraction of 90% (Figure 2), negativity for CD3, CD56, CD138, and Mum-1, which was in favor of the diagnosis of diffuse large B-cell lymphoma, germinal center Bcell type, stage IV. The patient suffered a relapse 4 months after the blood stem cell transplantation and was given cisplatin, dexamethasone, and high-dose cytarabine (DHAP) regimen with rituximab, administered concurrently with intrathecal chemotherapy (methotrexate, cytarabine, dexamethasone). The patient suffered severe marrow suppression and gave up all the treatments for financial difficulty and died 10 months after initial diagnosis
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