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Case Reports in Gastrointestinal Medicine
Volume 2014 (2014), Article ID 723473, 8 pages
http://dx.doi.org/10.1155/2014/723473
Case Report

NonHodgkin's Lymphoma with Peritoneal Localization

1University Clinic of Gastroenterohepatology, Medical Faculty, Ss. Cyril and Methodius University, Mother Teresa 17, 1000 Skopje, Macedonia
2University Clinic of Hematology, Medical Faculty, Ss. Cyril and Methodius University, Mother Teresa 17, 1000 Skopje, Macedonia
3University Clinic of Digestive Surgery, Medical Faculty, Ss. Cyril and Methodius University, Mother Teresa 17, 1000 Skopje, Macedonia

Received 9 December 2013; Accepted 23 January 2014; Published 9 March 2014

Academic Editors: O. I. Giouleme and H. Sugimura

Copyright © 2014 E. Curakova et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The gastrointestinal tract is the most common extranodal site involved with lymphoma accounting for 5–20% of all cases. Lymphoma can occur at any site of the body, but diffuse and extensive involvement of the peritoneal cavity is unusual and rare. We report a case of diffuse large B-cell lymphoma in a 57-year-old female infiltrating the peritoneum and omentum and presenting with ascites and pleural effusion. The performed examinations did not discover any pathological findings affecting the digestive tract or parenchymal organs, except for diffuse thickening of the peritoneum and omentum. Peripheral, mediastinal, or retroperitoneal lymphadenopathy was not registered. The blood count revealed only elevated leukocytes and on examination there were no immature blood cells in the peripheral blood. The cytology from the ascites and pleural effusion did not detect any malignant cells. Due to the rapid disease progression the patient died after twenty-two days of admission. The diagnosis was discovered postmortem with the histological examination and immunohistochemical study of the material taken during the surgical laparoscopy performed four days before the lethal outcome. Although cytology is diagnostic in most cases, laparoscopy with peritoneal biopsy is the only procedure which can establish the definitive diagnosis of peritoneal lymphomatosis.