Diffuse mantle cell lymphoma

Case contributed by Assoc Prof Craig Hacking

Presentation

One month of abdominal pain with nausea and vomiting. Referred by GP with clinically apparent abdominal mass. History of mantle cell lymphoma and not for further chemotherapy.

Patient Data

Age: 75 years
Gender: Male
CT

Large heterogeneous confluent soft tissue mass filling the para-aortic retroperitoneum and mesentery. The mass encases the abdominal aorta, and extends along the iliac vessels into the pelvis and both groins. It also encases the mesenteric vessels. The remaining peritoneal and mesenteric fat is hyperdense with inflammatory stranding.

There is reduction in caliber of the bilateral common and external iliac arteries and lower abdominal aorta. The vessels are patent. Iliac veins are not clearly identified. The remaining mesenteric and portal venous systems appear patent. Progression of the bilateral inguinal lymphadenopathy.

Spleen is enlarged more so than the previous study. The liver is unchanged. Gallbladder wall is mildly edematous. The pancreas is compressed by the mass. Bilateral kidneys remain mildly atrophic with unchanged renal cortical cysts.

Allowing for significant mass effect within the abdomen the large and small bowel appear normal. The bladder is normal.

No aggressive osseous lesions. Moderate bilateral pleural effusions with adjacent atelectasis of the bilateral lower lobes.

IMPRESSION

Extensive progression of lymphoma with retroperitoneal and mesenteric lymphadenopathy which is now a massive confluent soft tissue mass causing mass effect within the abdomen and encasing the retroperitoneal and mesenteric vessels. Bilateral pleural effusions.

Case Discussion

Example of the extent of lymphoma and its affect on vessels.

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Case information

rID: 79215
Published: 30th Jun 2020
Last edited: 30th Jun 2020
System: Oncology
Inclusion in quiz mode: Included

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