Woman 65 yo with anorexia, weigh loss # 5 kg in 3 months.
Ultrasound of abdomen for general check-up detected one round mass, mobile
at RLQ.
US 1 : hypoechoic
homogeneous mass looked like a cyst, size 3 cm, round border with low posterior
enhancement, intra mesenteric situation.
US 2 : CDI
vascular around this mass not branching inside this mass
US 3: CDI with another
section, no vascular in the mass
US 4 scanning by linear
14 MHz probe: this mas like
a cyst.
US 5 : elastoscan
of this mass mean 9 kPascal.
MSCT with CE=
CT 1:
crossed section of this mass very quick and high contrast enhanced,
CT 2: frontal section of this mass = intra mesentery
CT 3: sagittal
section of this mass: near anterior wall of abdomen
Blood tests= normal
CBC, negative all cancer markers.
DISCUSSIONS=
1. This mass is intra mesenteric area not related with GI TRACT
2. THIS MASS IS VERY HYPOECHOIC AND HOMOGENEOUS LOOKED LIKE A CYST BUT IT IS SOLID MASS
3. THIS MASS IS VERY QUICK AND HIGH CONTRAST ENHANCEMENT, HOMOGENEOUS STRUCTURE.
4. BLOOD TESTS BETA 2 MICROGLOBULINE and FERRITIN , LDH NOT RISING
THE FIRST CHOICE OF THIS MASS IS LYMPHOMA.
Laparoscopic operation detected the mass intra mesenteric jejunum; open surgery removed this mass out the abdomen cavity and web resection.
Microscopic report with immunohisto-staining is CASTLEMAN DISEASE.
REFERENCES: With 2 VMU Cases in the past.
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