Lymphoma with aneurysmal dilatation of the small bowel loops.

Case contributed by Dr Mohammad A. ElBeialy

Presentation

Abdominal pain.

Patient Data

Age: 50 years
Gender: Female
  • Extensive enlarged abdomino-pelvic lymph nodes seen mainly at the para-aortic, aorto-caval, mesenteric, porta-hepatis, as well as internal iliac groups variable in size up to 5.8 x 4.8 cm showing heterogenous CT density. No intrinsic calcifications.
  • Focal segmental pathologic process seen involving the distal ileal loop and to a lesser extent the terminal ileum at the ileo-cecal junction in the form of focal aneurysmal dilatation of the distal ileal loops within the pelvis, notable mucosal thickening with mild mucosal enhancement.
  • The liver is enlarged with diffuse low CT attenuation values denoting diffuse fatty changes. No hepatic focal lesion could be detected. No CT evidence of intra or extra hepatic biliary radicle dilatation.
  • The gall bladder is average in size with no hyperdense stones seen within.
  • Patent average calibre of the portal vein. 
  • Average size of the spleen. No splenic focal lesion.
  • Normal CT appearance of the kidneys, pancreas, aorta and IVC.
  • Average capacity of the urinary bladder. No masses or pathological wall thickening.
  • No ascites or pelvic collection.

Case Discussion

Enlarged pelvi-abdominal lymphadenopathy and hepatomegaly with aneurysmal dilatation of the distal ileum as well as focal segmental small bowel loops (ileal and ileo-cecal junction) thickening; highly impressive of abdominal nodal and small bowel lymphoma.

Non-Hodgkin's ymphoma was confirmed on nodal biopsy and histopathological examination.

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Case information

rID: 42085
Case created: 5th Jan 2016
Last edited: 4th Nov 2017
Inclusion in quiz mode: Included

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