Follicular lymphomatosis
Updates to Case Attributes
This case is characterized by lymphomatous infiltration throughout the abdomen and pelvis. The most striking manifestations of disease is the symmetric renal involvement and infiltration of the rectus abdominusabdominis musculature. Given the extensive nature of the disease (renal, spleen, probable small bowel, muscular, lymphoidnodal), it would be difficult to plausibly suggest any other diagnosis than lymphoma. If you had a case with the renal findings alone, a reasonable differential would include lymphoma, IgG4 deposition disease, amyloid, and Erdheim-Chester disease.
When reporting, it is most appropriate to suggest a potential target for biopsy, so that the clinician does not have to call the radiologist and ask: in this case, the large left inguinal lymph node is superficial and safe for ultrasound-guided biopsy.
-<p>This case is characterized by lymphomatous infiltration throughout the abdomen and pelvis. The most striking manifestations of disease is the symmetric renal involvement and infiltration of the rectus abdominus musculature. Given the extensive nature of the disease (renal, spleen, probable small bowel, muscular, lymphoid), it would be difficult to plausibly suggest any other diagnosis than lymphoma. If you had a case with the renal findings alone, a reasonable differential would include lymphoma, IgG4 deposition disease, amyloid, and Erdheim-Chester disease. </p><p>When reporting, it is most appropriate to suggest a potential target for biopsy, so that the clinician does not have to call the radiologist and ask: in this case, the large left inguinal lymph node is superficial and safe for ultrasound-guided biopsy. </p>- +<p>This case is characterized by lymphomatous infiltration throughout the abdomen and pelvis. The most striking manifestations of disease is the symmetric renal involvement and infiltration of the rectus abdominis musculature. Given the extensive nature of the disease (renal, spleen, probable small bowel, muscular, nodal), it would be difficult to plausibly suggest any other diagnosis than lymphoma. If you had a case with the renal findings alone, a reasonable differential would include lymphoma, <a title="IgG4-related disease" href="/articles/igg4-related-disease">IgG4 deposition disease</a>, <a title="Amyloidosis" href="/articles/amyloidosis">amyloid</a>, and <a title="Erdheim-Chester disease" href="/articles/erdheim-chester-disease">Erdheim-Chester disease</a>. </p><p>When reporting, it is most appropriate to suggest a potential target for biopsy, so that the clinician does not have to call the radiologist and ask: in this case, the large left inguinal lymph node is superficial and safe for ultrasound-guided biopsy.</p>
Updates to Study Attributes
Multiple organ systems are markedly abnormal: There is diffuse enlargement and low-attenuation infiltration of the kidneys, low attenuation splenic lesions, thickening of the proximal small bowel, retroperitoneal adenopathy, diffuse enlargement and irregularity of the inferior rectus abdominusabdominis musculature, and inguinal and pelvic adenopathy.
The non-contrast images were included for educational benefit, particularly how the renal abnormalities can still be appreciated (though subtle).
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