Presentation
Abdominal pain, ill-looking.
Patient Data
marked circumferential mural thickening of one of the bowel loops in the midline lower abdomen (most probably distal ileal loops) with luminal aneurysmal dilatation. Unilateral wall thickness is 1 cm
multiple hypoattenuating nodal masses in the midline lower abdominal cavity. The conglomerate of these nodal masses measure approximately 9 x 8 cm
multiple hypoattenuating round lesions in both kidneys
bilateral adrenal glands are replaced by large solid lesion.
a solid hypoattenuating lesion in the right atrium measuring 2 cm is seen on partially visualized chest
small effusion/pleural thickening in the dependent portion of right hemithorax
retroperitoneal prespinal and posterior mediastinal enlarged lymph nodes
Liver, spleen, gallbladder, bones and pancreas are normal. No ascites.
Case Discussion
The features are most suggestive of lymphoma involving the intestine, kidneys, adrenals, cardiac right atrium, abdominal lymph nodes and posterior mediastinal lymph nodes.
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