Peritoneal Lymphomatosis: Case Report

Peritoneal lymphomatosis is a rare manifestation of high grade lymphomas. Although it is difficult to differentiate peritoneal lymphomatosis from other peritoneal diseases such as peritoneal carcinomatosis and leiomyomatosis clinically and radiologically, it should be included in differential diagnosis because the disease is curable with chemotherapy. Consequently, radiologic diagnosis plays a very important role in the detection of this disease. We experienced two cases of peritoneal lymphomatosis with primary gastrointestinal lymphomas in the distal ileum. The two patients were 25 and 50-year-old males. Abdominal CT, ultrasound and barium study were performed on both patients. Both patients had non-Hodgkin's lymphoma confirmed with open or sonographically guided biopsies. Although radiologic appearances overlapped, characteristic findings of long-segmental circumscribed annular mass, aneurysmal luminal dilatation, small to moderate amount of ascites without septation or loculation, diffuse involvement of mesentery, omentum and peritoneum, and enlarged lymph nodes were helpful in narrowing the range of possible diagnoses.

Primary Serous Papillary Carcinoma of the Peritoneum: A Case Report

Primary serous papillary carcinoma of the peritoneum is a rare neoplasm arising from the mesothelium. Histologically it is indistinguisable from ovarian serous papillary carcinoma, but it should be free of tumor or involved only superficially with the ovary. Radiologically its common findings are peritoneal and omental masses with ascites, and it is indistinguisable from peritoneal carcinomatosis or malignant mesothelioma. We report a case of surgically proven primary serous papillary carcinoma of the peritoneum in a 63-year-old woman.

Primary Papillary Serous Carcinoma of the Peritoneum: A Case Report

Primary papillary serous carcinoma of the peritoneum is a rare primary tumor involving the peritoneum. Histologically, it is indistinguishable from serous ovarian papillary carcinoma, although it either spares the o-varies or only microscopically involves their surface. The characteristic features of this tumor are extensive peritoneal and omental masses or implants with psammomatous calcification, and ascites. In addition, it can occur focally in the pelvic peritoneum. We report the CT findings, with histopathologic correlation of primary papillary serous carcinoma of the peritoneum occurring in the upper mesorectum.

Localized Fluid Collection of Hepatic Bare Area in Children with Blunt Abdominal Trauma

PURPOSE: To investigate the incidence and significance of localized fluid collection in the hepatic bare area re-sulting from blunt abdominal trauma in children. Materias and Methods:We retrospectively reviewed the CT scans and medical records of eighty children with blunt abdominal trauma and evaluated the incidence of fluid collection in the hepatic bare area. The findings were correlated with the presence of injury to adjacent organs. RESULTS: Fluid collection in the hepatic bare area was noted in 23 of 80 patients (28.7%). Associated organ in-juries included liver laceration (17/23), contusion of the right hemidiaphragm (7/23), right adrenal injury (5/23), and right renal injury (5/23). In one patient, organic injury was not detected in spite of fluid collection in the hepatic bare area. Eight of 23 patients (34.8%) showed fluid collection in this area, but not intraperitoneally. CONCLUSION: Fluid collection in the hepatic bare area after blunt abdominal trauma was noted in about 30% of patients and was frequently accompanied by injury to adjacent organs. Since right hemidiaphragmatic contusion associated with fluid collection in the bare area was a not uncommon CT finding, close observation of the condition is warranted.

Extensive Peritoneal Calcifications Associated with Continuous Ambulatory Peritoneal Dialysis

Peritoneal calcification, which can lead to intestinal obstruction and potentially lethal hemoperitoneum, is a rare complication of continuous ambulatory peritoneal dialysis. We describe a case in which extensive peritoneal calcification had arisen for this reason. Although the patient was asymptomatic, extensive calcification was present on the parietal and visceral peritoneum, including the hepatic and splenic surface.

CT Features of Peritonitis associated with Continuous Ambulatory Peritoneal Dialysis

PURPOSE: To evaluate the CT findings of peritonitis associated with continuous ambulatory peritonealdialysis(CAPD). MATERIALS AND METHODS: We retrospectively analyzed CT scans of 14 symptomatic patients withperitonitis after CAPD. Diffuse abdominal pain was present in 11, fever in two, and abdominal mass with vomitingin one. The mean duration of CAPD ranged from 10 months to 5 years(mean : 3.9 years). On abdominal CT, weevaluated the presence and location of ascites, bowel wall thickening, cocoon formation, the pattern ofenhancement of peritoneal thickening, the presence of calcifications in the peritoneum, and mesenteric and omentalchange. RESULTS: On enhanced CT, multiloculated ascites was observed in all cases(n=14) ; it was located mainlyin the pelvic cavity with small multi-loculated fluid collections in the peritoneal cavity (n=13), including thelesser sac(n=3). In one patient, ascites was located in the space between the greater omentum and anteriorperitoneal surface. CT showed ileus in 12 cases, small bowel wall thickening in 11, and cocoon formation in five.Uneven but smooth thickening of the peritoneum, with contrast enhancement, was seen in eight cases, and in five ofthese, peritoneal thickening was more prominent in the anterior peritoneum. Other findings included reticularopacity in two cases, hematoma of the rectus muscle in one, and umbilical hernia in one. CONCLUSION:Multiloculated fluid collection, ileus, small bowel wall thickening, uneven but smooth peritoneal thickening, andcocoon formation appear to be CT features of CAPD peritonitis.

CT Findings of Peritoneal Tuberculosis and Peritoneal Carcinomatosis: Relationship between Peritoneal Change and Omental Infiltration

PURPOSE: To compare the CT findings of peritoneal tuberculosis (PT) and peritoneal carcinomatosis (PC) based on the morphologic features of the peritoneum and assess the relationship between the degree of peritoneal thickness and the severity of omental infiltration in PT and PC. MATERIALS AND METHODS: We retrospectively reviewed the CT findings of 15 patients with PT and 14 with PC. We checked the morphologic changes of the peritoneum as seen on CT, for the following points: 1) the presence of peritoneal change: 2) the pattern of any change-diffuse thickening, plaque or nodularity, combined thickening (diffuse and plaque, or nodularity); 3) the degree of thickness on the whole peritoneum - mild (grossly definite, but not more than 3 mm), moderate (more than 3mm); 4) the presence of irregularity on the peritoneal surface. We also evaluated the significance of the relationship between peritoneal thickness and omental infiltration in both disease entities. The degree of omental infiltration was described as follows : grade I (no change or focal smudge pattern); grade II ( diffuse smudge), grade III (omental cake regardless extent). RESULTS: Peritoneal change was seen in 12 of 15 PT patients and in 7 of 14 PC patients. In all 12 PT patients, the pattern of change was diffuse thickening, and among the seven PC patients, there was diffuse thickening in one, plaque or nodular thickening in four, and combined thickening in two. In PT patients, the degree of thickness on the whole peritoneum was mild in six and moderate in six, and in PC patients it was mild in two and moderate in one. An irregular peritoneum surface was seen in one patient with PT and in two with PC. The degree of omental infiltration in PT was grade I in four patients, grade II in six andgrade III in five. In PC, it was grade I in six patients, grade II in two and grade III in six. Smooth diffuse thickening of the peritoneum was seen in 11 of 15 PT cases and in one of 14 PC (P0.5). CONCLUSION: In PT and PC different CT findings based on peritoneal morphologic changes might be useful in differentiating these two entities. In addition, careful observation of relationship between the peritoneal change and the severity of omental infiltration is necessary.

Multicystic Mesothelioma of the peritoneum: A case Report

We report a case of multicystic mesothelioma in the visceral peritoneum anterior of the ascending colon. A 39-year-old female patient visited hospital with a palpabel tender mass in the right flank. An ultrasonogram showed multiple cystic mass lesions in the right flank and CT scan showed a multicystic rative mass with enhancing wall and septum in front of the ascending colon. The patient underwent explolaparotomy and the mass. which inpathology turned out to be a benign multicystic masothelioma, was removed.