Weng Shuo-Chun, Wu Chun-Ying
Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
J Chin Med Assoc. 2008 Dec;71(12):646-50. doi: 10.1016/S1726-4901(09)70009-7.
Multiple intra-abdominal organ infiltration or disseminated peritoneal lymphoma receives much less attention than peritoneal carcinomatosis in clinical practice. This may be due to its relatively infrequent occurrence. In this report, an 89-year-old woman was diagnosed with disseminated peritoneal lymphoma with gastric and rectal involvement and marked ascites. Flow cytometry of the surface markers for ascites showed positive results for CD19, CD20 and CD45. Biopsy of the stomach and rectum were all reported to show diffuse large B-cell lymphoma. The cytology of ascites is a simple and effective method for making a diagnosis from adequate samples with time limitations. The management of this disease depends on the individual case. It must be kept in mind that differential diagnosis from other pathologic entities with similar imaging features or high ascitic fluid adenosine deaminase levels is difficult because of considerable overlap of clinical features. To prolong the survival of patients with peritoneal lymphomatosis, diagnosis should be made as early as possible.
在临床实践中，腹腔内多个器官浸润或播散性腹膜淋巴瘤比腹膜癌病受到的关注要少得多。这可能是由于其相对较少发生。在本报告中，一名89岁女性被诊断为伴有胃和直肠受累及大量腹水的播散性腹膜淋巴瘤。腹水表面标志物的流式细胞术显示CD19、CD20和CD45呈阳性结果。胃和直肠活检均报告显示为弥漫性大B细胞淋巴瘤。腹水细胞学检查是一种从有时间限制的充足样本中进行诊断的简单有效方法。这种疾病的治疗取决于个体情况。必须牢记，由于临床特征有相当大的重叠，与具有相似影像学特征或高腹水腺苷脱氨酶水平的其他病理实体进行鉴别诊断很困难。为延长腹膜淋巴瘤患者的生存期，应尽早做出诊断。
