Presentation
Abdominal pain.
Patient Data
Age: 50 years
Gender: Female
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- Extensive enlarged abdomino-pelvic lymph nodes seen mainly at the para-aortic, aorto-caval, mesenteric, porta-hepatis, as well as internal iliac groups variable in size up to 5.8 x 4.8 cm showing heterogenous CT density. No intrinsic calcifications.
- Focal segmental pathologic process seen involving the distal ileal loop and to a lesser extent the terminal ileum at the ileo-cecal junction in the form of focal aneurysmal dilatation of the distal ileal loops within the pelvis, notable mucosal thickening with mild mucosal enhancement.
- The liver is enlarged with diffuse low CT attenuation values denoting diffuse fatty changes. No hepatic focal lesion could be detected. No CT evidence of intra or extra hepatic biliary radicle dilatation.
- The gall bladder is average in size with no hyperdense stones seen within.
- Patent average caliber of the portal vein.
- Average size of the spleen. No splenic focal lesion.
- Normal CT appearance of the kidneys, pancreas, aorta and IVC.
- Average capacity of the urinary bladder. No masses or pathological wall thickening.
- No ascites or pelvic collection.
Case Discussion
Enlarged pelvi-abdominal lymphadenopathy and hepatomegaly with aneurysmal dilatation of the distal ileum as well as focal segmental small bowel loops (ileal and ileo-cecal junction) thickening; highly impressive of abdominal nodal and small bowel lymphoma.
Non-Hodgkin's ymphoma was confirmed on nodal biopsy and histopathological examination.
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