Presentation
Abdominal pain with a large mass feeling on physical exam.
Patient Data
Multiple conglomerate lymphadenopathy are seen in the para-aortocaval regions that encase the aorta and its main branches and displace them anteriorly, causing a floating aorta sign.
In addition, several low-enhancing masses are seen in the liver less than 135 mm. The large masses show internal cystic/ necrotic changes.
The spleen is mildly enlarged, and its cephalocaudal height measured 130 mm.
Case Discussion
Pathology-proven diffuse large B-cell lymphoma with para-aortocaval lymphadenopathy causes a typical floating aorta sign and liver involvement.
The floating aorta sign refers to displacing the abdominal aorta away from the vertebral column by the retroperitoneal mass and most commonly suggests a lymphoma diagnosis.
Rarely, other diseases with diffuse retroperitoneal mass, such as Castleman's disease, primary retroperitoneal sarcomas, metastatic testicular cancer and tuberculous adenitis, may mimic a similar appearance.
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