Presentation
Abdominal pain and progressive distension. Abdominal palpable mass on physical exam.
Patient Data
Several enlarged lymph nodes are seen at the AP window, sub-carina and right hilar regions with SAD less than 18 mm. There are also multiple bilateral axillary enlarged lymph nodes with a maximum SAD of 22 mm.
A 65 x 105 x 130 mm soft tissue density mass is present at para-aortic regions that encase the aorta and its main branches. The mass displaces the left kidney laterally, encases the left kidney hilar structures and seems to infiltrate the left renal hilum. In addition, several enlarged mesenteric and distal para aortocaval lymph nodes are evident.
Multiple ill-defined low-enhancing masses are seen at the liver less than 50 mm.
The spleen is enlarged and its cephalocaudal height measured 132 mm.
Multiple enlarged lymph nodes are seen at para iliac and inguinal regions bilaterally with SAD less than 27 mm.
The prostate gland is enlarged.
Case Discussion
Pathology-proven multi-organ non-Hodgkin lymphoma with extra-nodal involvement of the liver and left renal sinus.