scholarly journals Peritoneal Tuberculosis Mimicking Peritoneal Carcinomatosis

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Mehmet Akce ◽  
Sarah Bonner ◽  
Eugene Liu ◽  
Rebecca Daniel
Keyword(s):  
Weight Loss ◽  
Peritoneal Carcinomatosis ◽  
Biopsy Specimen ◽  
Exploratory Laparotomy ◽  
Peritoneal Tuberculosis ◽  
Blood Cell Count ◽  
Purified Protein Derivative ◽  
Acid Fast Bacilli ◽  
Omental Caking ◽  
Necrotizing Granulomas

A 67-year-old male presented with fatigue, abdominal pain , and 30-pound weight loss over 3 months. Computerized tomography (CT) abdomen displayed ascites with thickening and enhancement of the peritoneum and mottled nodular appearing as soft tissue consistent with omental caking worrisome for peritoneal carcinomatosis. A paracentesis revealed white blood cell count of 2,500 with 98% lymphocytes and serum ascites albumin gradient of 0.9 g/L. No acid-fast bacilli were seen by microscopic exam and culture was negative. Purified protein derivative skin test (PPD) was negative and CXR did not reveal any infiltrates. Esophagogastroduodenoscopy (EGD) and colonoscopy were unrevealing. The patient underwent exploratory laparotomy with round ligament and peritoneal biopsies that revealed numerous necrotizing granulomas. Acid-fast bacteria Ziehl-Neelsen stain (AFB) of the biopsy specimen revealed single acid-fast bacilli. Treatment for M. tuberculosis was initiated and final culture revealed that mycobacterium tuberculosis was sensitive to Isoniazid, Rifampin, Ethambutol, and Pyrazinamide. After 6 months of treatment, the ascites and peritoneal carcinomatosis resolved.

Peritoneal Tuberculosis: A Retrospective Review of 20 Cases and Comparison With Primary Peritoneal Carcinoma

2010 ◽  
Vol 20 (5) ◽  
pp. 798-803 ◽  
Author(s):  
Chel Hun Choi ◽  
Chul-Jung Kim ◽  
Yoo-Young Lee ◽  
Joo Sun Kim ◽  
Taejong Song ◽  
...  
Keyword(s):  
Retrospective Review ◽  
Medical Center ◽  
Control Sample ◽  
Exploratory Laparotomy ◽  
Tissue Reaction ◽  
Ca 125 ◽  
Peritoneal Tuberculosis ◽  
Cancer Antigen 125 ◽  
Peritoneal Carcinoma ◽  
Primary Peritoneal Carcinoma

Introduction:To evaluate the clinical features of peritoneal tuberculosis (TB) and to compare them with those of primary peritoneal carcinoma (PPC).Methods:We conducted a retrospective review of women with peritoneal TB who were managed at Samsung Medical Center from January 1996 to October 2006. As a control sample, patients with a diagnosis of PPC during the same period were also selected for comparison.Results:During the study period, we identified 20 female patients with peritoneal TB. The median age was 39 years (range, 23-69 years), and the median cancer antigen 125 (CA-125) level was 448 U/mL (range, 32-1725 U/mL). Seventeen patients with PPC whom we examined were older, with a median age of 63 years (range, 50-73 years); their median CA-125 level was higher at 1848 U/mL (range, 42-14,380 U/mL). Compared with those of PPC, the radiologic findings of peritoneal TB indicated less severe involvement of the omentum and the mesentery (P = 0.03). Among the 20 patients who underwent operations, 6 (30%) underwent exploratory laparotomy; 12 (60%), diagnostic laparoscopy; and 2 (10%), laparoscopy converted to laparotomy because of severe adhesion. Frozen tissue sections revealed chronic granulomatous tissue reaction in 15 (83.3%) of 18 women with peritoneal TB.Conclusions:Maintaining a high index of suspicion is very important for the successful treatment of peritoneal TB, especially in developing countries. Age, CA-125 level, and omental involvement as identified by computed tomography may be helpful for the differential diagnosis of peritoneal TB and PPC.

Endocervical adenocarcinoma associated with lobular endocervical glandular hyperplasia showing rapid reaccumulation of hydrometra

2008 ◽  
Vol 18 (6) ◽  
pp. 1285-1288 ◽  
Author(s):  
K. Takeuchi ◽  
T. Tsujino ◽  
M. Sugimoto ◽  
S. Yoshida ◽  
S. Kitazawa
Keyword(s):  
Biopsy Specimen ◽  
Unknown Origin ◽  
Exploratory Laparotomy ◽  
Pelvic Lymphadenectomy ◽  
Imaging Studies ◽  
Endocervical Adenocarcinoma ◽  
Total Hysterectomy ◽  
Carcinoma Tissue ◽  
Biopsy Specimens ◽  
Adenocarcinoma Cells

Mucinous endocervical adenocarcinoma is characterized by increased watery vaginal discharge, but the early diagnosis is sometimes difficult because biopsy specimen might only serve to sample a superficial part of the tumor. The patient presented with complaints of abdominal distention. No vaginal bleeding or watery discharge was observed. Hydrometra was suspected by imaging studies. Rapid reaccumulation of hydrometra was seen despite drainage. Papanicolaou smear of endocervix and endometrium followed by fractional curettage was performed, but failed to confirm the diagnosis. To investigate the unknown origin of hydrometra, an exploratory laparotomy with total hysterectomy and bilateral salpingo-oophorectomy was performed, followed by pelvic lymphadenectomy because biopsy specimens during operation suggested adenocarcinoma of the cervix. The final pathologic study of surgical specimens revealed mucinous adenocarcinoma, which was located on the proximal area of cervix. Adjacent to carcinoma tissue, lobular endocervical glandular hyperplasia (LEGH) was detected. Pyloric gland mucin (HIK1083), MUC6, and MUC5AC were diffusely immunopositive in the cytoplasm of LEGH cells and the immunoreactivity became weaker in adenocarcinoma cells with tumor progression and loss of differentiation. Based on histopathologic features of the present case, there seems to be a possible link between LEGH and conventional mucinous endocervical adenocarcinomas. The physician should keep in mind the possible existence of endocervical adenocarcinoma in a patient showing rapid reaccumulation of hydrometra, when uterine malignancies are clinically suspected and biopsy finding fails to confirm the diagnosis.

Intestinal lymphoma in a Boxer breed dog – case report

2019 ◽  
Vol XXIV (142) ◽  
pp. 72-82
Author(s):  
Sayonara da Luz Ferro ◽  
Fernanda Jönck ◽  
Marta Cristina T. Heckler ◽  
Ewerton Cardoso ◽  
Mateus Rychescki ◽  
...  
Keyword(s):  
Weight Loss ◽  
Abdominal Cavity ◽  
Clinical Signs ◽  
Exploratory Laparotomy ◽  
Needle Aspiration ◽  
Free Fluid ◽  
Intestinal Lymphoma ◽  
Mesenteric Lymph Nodes ◽  
Abdominal Ultrasonography ◽  
Tissue Biopsy

Intestinal lymphoma is the second most common form of lymphoma in dogs. It is characterized by the presence of neoplastic lymphocytes in the gastrointestinal tract or mesenteric lymph nodes. The chief clinical signs are vomiting, diarrhea, anorexia and weight loss. The diagnosis is made through fine needle aspiration and cytology, or by tissue biopsy and histopathology, and chemotherapy is the treatment of choice. We report a case of intestinal lymphoma in a five years old Boxer, presented with history of hematochezia and lethargy of 7 days duration, and 20 days of anorexia and persistent weight loss. Abdominal ultrasonography revealed free fluid in the abdominal cavity, and an intestinal mass. Exploratory laparotomy was performed and a tissue biopsy was performed. Histopathology confirmed the diagnosis of intestinal lymphoma, but the patient died during the surgical procedure.

scholarly journals Lymphoplasmacytic Sclerosing Pancreatitis and Retroperitoneal Fibrosis

HPB Surgery ◽  
2008 ◽  
Vol 2008 ◽  
pp. 1-3
Author(s):  
Nigel K. F. Koo Ng ◽  
Jin J. Bong ◽  
Robin C. Williamson
Keyword(s):  
Weight Loss ◽  
Obstructive Jaundice ◽  
Retroperitoneal Fibrosis ◽  
Exploratory Laparotomy ◽  
Uneventful Recovery ◽  
Frozen Sections ◽  
Idiopathic Retroperitoneal Fibrosis ◽  
Biliary Bypass ◽  
Lymphoplasmacytic Sclerosing Pancreatitis ◽  
Sclerosing Pancreatitis

Although cases of lymphoplasmacytic sclerosing pancreatitis (LSP) associated with idiopathic retroperitoneal fibrosis have been reported, the association is rare. We describe a 74-year-old man who presented with obstructive jaundice and weight loss. Nineteen months earlier, he had been diagnosed with idiopathic retroperitoneal fibrosis and treated with bilateral ureteric stents. Initial investigations were suggestive of a diagnosis of LSP, however, a malignant cause could not be ruled out. He underwent an exploratory laparotomy and frozen sections confirmed the diagnosis of LSP. An internal biliary bypass was performed using a Roux loop of jejunum, and the patient made an uneventful recovery. This case illustrates the difficulty in distinguishing LSP from pancreatic carcinoma preoperatively.

scholarly journals Gastrodudenal Intussusception Secondary to a Gastric Lipoma

2005 ◽  
Vol 19 (2) ◽  
pp. 107-108 ◽  
Author(s):  
Fausto Y Vinces ◽  
Joseph Ciacci ◽  
David C Sperling ◽  
Steven Epstein
Keyword(s):  
Weight Loss ◽  
Diagnostic Laparoscopy ◽  
Medical Literature ◽  
Clinical Presentation ◽  
Exploratory Laparotomy ◽  
Diagnostic Workup ◽  
Nausea And Vomiting ◽  
Gastroduodenal Intussusception ◽  
Uncommon Condition ◽  
Gastric Lipoma

Gastroduodenal intussusception caused by a gastric lipoma is an uncommon condition, and only a few cases have been reported in the medical literature. A case of a 72-year-old man who complained of weight loss and intermittent episodes of nausea and vomiting is presented. Diagnostic workup demonstrated a mass in the second portion of the duodenum. The patient underwent a diagnostic laparoscopy followed by an exploratory laparotomy that confirmed the gastroduodenal intussusception by a gastric lipoma. In addition, the anatomical and clinical presentation, diagnosis and management of this entity are discussed.

Peritoneal tuberculosis simulating advanced ovarian carcinoma: is clinical impression sufficient to administer neoadjuvant chemotherapy for advanced ovarian cancer?

2006 ◽  
Vol 16 (Suppl 1) ◽  
pp. 307-312
Author(s):  
A. Gurbuz ◽  
A. Karateke ◽  
C. Kabaca ◽  
G. Kir ◽  
E. Cetingoz
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Frozen Section ◽  
Clinical Signs ◽  
Advanced Ovarian Cancer ◽  
Signs And Symptoms ◽  
Exploratory Laparotomy ◽  
Clinical Impression ◽  
Peritoneal Tuberculosis ◽  
Clinical Signs And Symptoms

Peritoneal tuberculosis mimics advanced ovarian cancer because of the similarities in clinical signs and symptoms such as ascites, pelvic and abdominal pain and mass, and elevation of serum CA125 level. We have presented four cases of peritoneal tuberculosis that underwent exploratory laparotomy for suspected advanced ovarian cancer during a 3-year period. Definitive diagnosis of tuberculosis was performed at laparotomy in all the cases. The frozen-section analysis seems to be the gold standard in the differential diagnosis. In view of these data, clinical diagnosis of advanced ovarian cancer is not sufficient for administering neoadjuvant chemotherapy. Cytologic or pathologic findings must be consistent with ovarian cancer for candidates who are being considered for neoadjuvant chemotherapy.

scholarly journals T-cell lymphoproliferative disorder of hand-mirror cell morphology presenting in an eosinophilic loculated peritoneal effusion, with omental "caking"

CytoJournal ◽  
2006 ◽  
Vol 3 ◽  
pp. 13 ◽  
Author(s):  
Richard Siderits ◽  
Janusz Godyn ◽  
Dearon Tufankjian ◽  
Osman Ouattara
Keyword(s):  
T Cell ◽  
Peritoneal Carcinomatosis ◽  
Cell Morphology ◽  
Gene Rearrangement ◽  
Cell Receptor ◽  
Diagnostic Study ◽  
Abdominal Girth ◽  
Peritoneal Effusion ◽  
Omental Caking ◽  
Monomorphic Population

Background: Cells with hand mirror morphology have not, to the best of our knowledge, been described in a primary effusion sample. This paper describes a case of T-cell lymphoma with eosinophilia in a patient with suspected peritoneal carcinomatosis. Rarely, a T-cell lymphoproliferative process may mimic primary peritoneal carcinomatosis, clinically suggested by a presentation in CT imaging of omental caking with bilateral massive loculated effusions in a patient without lymphadenopathy or splenomegaly. Methods: A 60 year old caucasian male presented with vague abdominal discomfort and increasing abdominal girth. Computed tomography showed a two centimeter thick omental cake and a small loculated effusion. The clinical presentation and imaging findings were most consistent with peritoneal carcinomatosis. Cytologic evaluation of the effusion was undertaken for diagnostic study. Results: Rapid intraprocedural interpretation of the effusion sample showed a monomorphic population of cells with hand-mirror cell morphology exhibiting cytoplasmic extensions (uropodia) with 3-5 course dark cytoplasmic granules and a rim of vacuolated cytoplasm capping the opposing mirror head side. These cells were seen within a background of mature eosinophils. Flow cytometric evaluation of the ascites fluid demonstrated an atypical T-cell population with the following immunophenotype: CD2-, CD3+, CD4-, CD5-, CD7-, CD8+, CD56+. T-cell receptor (TCR) gene rearrangement was positive for clonal TCR-gamma gene rearrangement, supporting the diagnosis of a T-lymphoprolifereative disorder. Conclusion: A T-cell lymphoproliferative process may present with hand mirror morphology in an effusion sample. These cells may show polar cytoplasmic vacuolization and 3-5 course granules within the handle of these unique cells. Cytoplasm shows peripheral constriction around the nucleus.

scholarly journals Primary Pleomorphic Liposarcoma of Liver: A Case Report and Review of the Literature

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
P. R. Thippeswamy Naik ◽  
Prem Kumar ◽  
P. Vinod Kumar
Keyword(s):  
Weight Loss ◽  
Male Patient ◽  
Clinical Course ◽  
Exploratory Laparotomy ◽  
Left Lobe ◽  
Review Of The Literature ◽  
Primary Malignancy ◽  
Pleomorphic Liposarcoma ◽  
Pain Abdomen ◽  
Adult Male Patient

Primary liver liposarcoma is a rare disease. The knowledge of the clinical course, management, and prognosis of primary liver liposarcoma are all limited because of its rarity. Twelve cases of primary liposarcoma of the liver have been previously reported. We present the thirteenth case, which occurred in an adult male patient. A 42-year-old male patient came to our outpatient department with complaints of pain abdomen, mass per abdomen, and weight loss. Ultrasonography showed a mass arising from the the left lobe of liver. CT abdomen showed a heterogenous enhancing mass from left lobe of liver with multiple cystic and necrotic areas compressing the stomach and spleen with no evidence of metastasis. Differential diagnosis included adenoma and primary malignancy. Exploratory laparotomy and resection were done. HPE was found to be pleomorphic liposarcoma of liver.

scholarly journals Role of laparoscopy in the Etiologic Diagnosis of Ascites of Unknown Origin

2017 ◽  
Vol 13 (1) ◽  
pp. 13-16
Author(s):  
Anup Sharma ◽  
P. Thapa ◽  
S. N. Gupta
Keyword(s):  
Positive Predictive Value ◽  
Peritoneal Carcinomatosis ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
College Teaching ◽  
Unknown Origin ◽  
Peritoneal Tuberculosis ◽  
Medical College ◽  
Etiologic Diagnosis

Introduction: Ascites is a consequence of many different etiologies, such as liver cirrhosis, neoplasm, tuberculous peritonitis, pyogenic peritonitis, congestive heart failure, renal and pancreatic diseases but, in some situations, ascites is of unknown cause in spite of comprehensive study. The aim of this study was to identify the role of laparoscopy in the etiological diagnosis of ascites of unknown origin.Methods: This was a prospective study of the patients who underwent diagnostic laparoscopy to determine the causes of ascites of unknown origin in the Department of Surgery, Nepalgunj Medical College Teaching Hospital from April 2012 to May 2014. All the patients underwent laparoscopy for the evaluation of ascites after appropriate clinical and laboratory examinations, which failed to reveal the cause.Results: Peritoneal tuberculosis and carcinomatosis peritonei were the two most common causes found in 37.14% and 57.14% of cases respectively. The average age of the patients was 52 years. Distension of abdomen, abdominal pain and weight loss were the most frequently observed symptoms in 33 patients (100%), 26 patients (74.28%) and 18 patients (51.42%) respectively. The CT scan findings, were a omental thickening in 28 cases (80%), peritoneal nodules in 7(20%) patients and the intraabdominal lymph nodes in 13 patients (39.39%). Ovarian mass was found in 4 patients (11.42%). The histological diagnosis was a peritoneal carcinomatosis in 13 (37.14%) patients and peritoneal tuberculosis in 20 (57.1%) patients and in two patients nonspecific inflammation. The sensitivity and specificity of laparoscopic diagnosis in the diagnosis of peritoneal tuberculosis were 78.67% and 98.6% respectively and in the diagnosis of peritoneal carcinomatosis were 94.78% and 72.2% respectively. The positive predictive value was 97.3% and the negative predictive value was 73.7% for peritoneal tuberculosis and for peritoneal carcinomatosis the positive predictive value was 83.7% and negative predictive value was 94.87%.Conclusion: The etiologic diagnosis of ascites of unknown origin is difficult despite the availability of several tests. Laparoscopy with peritoneal biopsy has still got a role in diagnosing these types of ascites where the other laboratory and imaging studies fail to reveal the cause.Journal of Nepalgunj Medical College Vol.13(1) 2015: 13-16

Sign in / Sign up

Export Citation Format

Share Document