Curakova E, Genadieva-Dimitrova M, Misevski J, Caloska-Ivanova V, Andreevski V, Todorovska B, Isahi U, Trajkovska M, Misevska P, Joksimovic N, Genadieva-Stavric S, Antovic S, Jankulovski N
University Clinic of Gastroenterohepatology, Medical Faculty, Ss. Cyril and Methodius University, Mother Teresa 17, 1000 Skopje, Macedonia.
University Clinic of Hematology, Medical Faculty, Ss. Cyril and Methodius University, Mother Teresa 17, 1000 Skopje, Macedonia.
Case Rep Gastrointest Med. 2014;2014:723473. doi: 10.1155/2014/723473. Epub 2014 Mar 9.
The gastrointestinal tract is the most common extranodal site involved with lymphoma accounting for 5-20% of all cases. Lymphoma can occur at any site of the body, but diffuse and extensive involvement of the peritoneal cavity is unusual and rare. We report a case of diffuse large B-cell lymphoma in a 57-year-old female infiltrating the peritoneum and omentum and presenting with ascites and pleural effusion. The performed examinations did not discover any pathological findings affecting the digestive tract or parenchymal organs, except for diffuse thickening of the peritoneum and omentum. Peripheral, mediastinal, or retroperitoneal lymphadenopathy was not registered. The blood count revealed only elevated leukocytes and on examination there were no immature blood cells in the peripheral blood. The cytology from the ascites and pleural effusion did not detect any malignant cells. Due to the rapid disease progression the patient died after twenty-two days of admission. The diagnosis was discovered postmortem with the histological examination and immunohistochemical study of the material taken during the surgical laparoscopy performed four days before the lethal outcome. Although cytology is diagnostic in most cases, laparoscopy with peritoneal biopsy is the only procedure which can establish the definitive diagnosis of peritoneal lymphomatosis.
胃肠道是淋巴瘤最常见的结外受累部位，占所有病例的5%-20%。淋巴瘤可发生于身体的任何部位，但弥漫性广泛累及腹膜腔并不常见且罕见。我们报告一例57岁女性弥漫性大B细胞淋巴瘤，浸润腹膜和大网膜，表现为腹水和胸腔积液。除腹膜和大网膜弥漫性增厚外，所进行的检查未发现任何影响消化道或实质器官的病理结果。未发现外周、纵隔或腹膜后淋巴结肿大。血常规仅显示白细胞升高，检查发现外周血中无幼稚血细胞。腹水和胸腔积液的细胞学检查未发现任何恶性细胞。由于疾病进展迅速，患者入院22天后死亡。在致命结局前4天进行的手术腹腔镜检查所取材料的组织学检查和免疫组化研究在尸检后确诊。虽然在大多数情况下细胞学检查可确诊，但腹腔镜检查及腹膜活检是唯一能明确诊断腹膜淋巴瘤病的方法。
