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B-cell lymphoma of the mesentery

Case contributed by Michael P Hartung
Diagnosis certain

Presentation

Abdominal discomfort.

Patient Data

Age: 65 years
Gender: Female

Hazy nodal soft tissue mass in the root of the mesentery. Few enlarged retroperitoneal nodes. 

PATHOLOGY REPORT
Mesenteric lymph node fine needle aspirate is received.

MICROSCOPIC:
Flow Cytometry Immunophenotyping Results:
Cytospin of the mesenteric lymph node FNA for flow cytometry shows a monotonous population of small lymphocytes, some with irregular nuclear borders, with interspersed larger lymphocytes with prominent nucleoli.

Population Reported: B-lymphocytes
Abnormal cells:  85 % of flow events

FINAL DIAGNOSIS:
Mesenteric lymph node, fine needle aspirate, flow cytometry:
-CD10-positive B-cell lymphoma

Case Discussion

This case serves as a good companion and distinction to sclerosing mesenteritis, which can also present with a soft tissue mass in the mesentery. In this case, the mass is bulky and nodal, which is much more suggestive of lymphoma. A few enlarged retroperitoneal lymph nodes also favor this diagnosis. This was biopsied using a transabdominal approach with ultrasound. 

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