scholarly journals Retroperitoneal Mass: Lymphoma as Differential Diagnosis to Retroperitoneal Fibrosis: Case Report

2022 ◽  
Vol 4 (1) ◽  
Author(s):  
Madalina Nussberger ◽  
Olaf Chan-Hi Kim ◽  
Sergio Cogliatti ◽  
Gautier Müllhaupt ◽  
Thomas Neumann

AbstractThe etiology of solid retroperitoneal mass may be autoimmune or neoplastic and should be investigated by imaging and histology. The spectrum of differential diagnoses includes retroperitoneal fibrosis and retroperitoneal tumors. As treatment for these entities differs substantially, early and accurate diagnosis is essential. We present a case of a 54-year-old woman admitted to our hospital with stroke-like symptoms. Suspecting vasculitis, magnetic resonance imaging of the head and abdomen was performed, which revealed circular enhancement of the internal carotid artery as well as retroperitoneal and periaortic masses. In light of the radiographic findings, an autoimmune process, such as retroperitoneal fibrosis, was hypothesized. Steroid treatment was initiated but did not lead to significant remission. Re-evaluation of the mass with fine-needle aspiration did not show malignant cells while diagnostic surgery and histological assessment revealed neoplastic lymphoproliferation. The final diagnosis was a non-Hodgkin B-cell lymphoma. Chemo- and immunotherapy were initiated. Follow-up abdominal computed tomography revealed significant remission of the retroperitoneal mass. Initially, the retroperitoneal mass was highly suspicious for RF. While imaging can be useful, obtaining histology should always be considered when there is an uncertain clinical presentation. Without histology, we would have missed a non-Hodgkin B-cell lymphoma in this case. Minimally invasive techniques such as fine-needle aspiration may be practical but can give false-negative results.

2021 ◽  
Author(s):  
Madalina Nussberger ◽  
Olaf Kim ◽  
Sergio Cogliatti ◽  
Thomas Neumann

Abstract Background The nature of a solid retroperitoneal mass can either be autoimmune or neoplastic and should be investigated by imaging and histology. The spectrum of differential diagnoses includes primarily retroperitoneal fibrosis and retroperitoneal tumors. Because treatments of retroperitoneal fibrosis and retroperitoneal tumors vary substantially, accurate and early diagnosis is highly relevant. Case presentation We present a case of a fifty-four-year old woman that was admitted to our hospital with stroke like symptoms. Suspecting a vasculitis, magnet resonance imaging of the head and abdomen were done, which revealed a circular enhancement of a cranial vessel as well as retroperitoneal and peri-aortic masses. Concerning this specific radiographic patterns, an autoimmune process like retroperitoneal fibrosis was hypothesized. Steroid treatment did not lead to significant remission though. On re-evaluation of the mass because of refractory disease, fine needle aspiration did not show malignant cells while surgery and histologic assessment revealed neoplastic lymphoproliferation. The final diagnosis was a non- Hodgkin B- Cell Lymphoma. Chemo- and Immunotherapy was initiated. A control abdominal computer tomography was performed which revealed a significant remission of the retroperitoneal mass. Conclusion Initially, the retroperitoneal mass was highly suspicious for RF. The results of imaging can be useful, however, histology should always be taken into consideration when there is an uncertain clinical presentation. Without histology we would have missed a non-Hodgkin B-Cell Lymphoma in this case. Minimal invasive techniques like fine needle aspiration may be practical but can demonstrate false negative results.


Suizo ◽  
2020 ◽  
Vol 35 (2) ◽  
pp. 213-221
Author(s):  
Ai KASAI ◽  
Shinichi HASHIMOTO ◽  
Kengo TSUNEYOSHI ◽  
Masayuki KABAYAMA ◽  
Hiromichi IWAYA ◽  
...  

2004 ◽  
Vol 31 (1) ◽  
pp. 52-56 ◽  
Author(s):  
Yusef M. Al-Marzooq ◽  
Rajan Chopra ◽  
Mohammed Younis ◽  
Abdulrahman S. Al-Mulhim ◽  
Mohammed I. Al-Mommatten ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document