P45 | An uncommon case of peritoneal carcinomatosis
S. Conci, M. Masetti, C. Oliveri, S. Cozzio | Ospedale S. Maria del Carmine, Rovereto (TN), Italy
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Background: The term peritoneal carcinomatosis, firstly coined to describe the spread of ovarian tumors into peritoneal serous membrane, usually configures settings of recurrent and/or advanced solid cancers, such as ovary, colon, lung, pancreas or liver malignancies.More rarely non-solid tumors and non-neoplastic conditions can closely mimic peritoneal carcinomatosis at clinical presentation and imaging.
Case report: A 60-year-old man presented with a two-weeks history of generalized abdominal pain, associated with hyporexia and weight loss. Outpatient abdominal ultrasound described moderate ascites. Abdomen CT showed multiple, diffuse nodular peritoneal lesions associated with free fluid.Colonoscopy was negative. Tumor markers, Quantiferon test, Lactate Dehydrogenase, Blood Cells Flow Cytometry were negative.He underwent diagnostic laparoscopy: macroscopically peritoneal carcinomatosis was confirmed.Histology showed a B cell non-Hodgkin lymphoma, Diffuse Large B cell lymphoma, anaplastic variant (A-DLBCL).The patient performed a PET-CT and a bone marrow biopsy, negative for neoplastic infiltration.He started R-CHOP treatment. Peritoneal lymphomatosis is an uncommon cause of rapid abdominal distention development.
Conclusions: Diagnosis is challenging because of overlap with other presentations, such as solid malignancies, liver disease or sarcomatosis.A-DLBCL is an uncommon distinct morphologic DLBCL variant characterized by large polygonal cells with bizarre pleomorphic nuclei resembling cells of anaplastic large cell lymphoma (ALCL) or Hodgkin lymphoma.It accounts for 1–3.5% of all newly diagnosed DLBCL cases.
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