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Sunday, 14 January 2018

CASE 471: MESENTERIC LYMPHOMA, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.


Man 70yo  with  epigastric pain. Ultrasound of abdomen detected  one hypoechoic mass like a cyst # 4.9cm near SMA.
US 1=   longitudinal scan at epigastric area.

US 2 = CDI:   this mass  is near SMA.

US  3 = crossed scanning= this mass  is placed over the head of pancreas in relation  with  celiac artery and vein.

US 4=  some  small lymph nodes near the big anesthetic mass.


MSCT CE=
CT  1 : crossed section  this mass  over the artery and vein.


CT 2:  the pancreas is normal.

   
CT 3:  frontal section of this intramesenteric mass near  SMA and vein   with some  lymph nodes in mesentery.


Endoscopy gastric and colon are normal, blood test and all cancer markers are normal 

Laparotomy for  biopsy= many nodes in mesentery.
Microscopic with histobiochemistry  is  follicular B CELL LYMPHOMA.




SUMMARY :  MANY LYMPH NODES IN MESENTERY  WITH TYPICAL APPEARANCE HYPOECHOIC PATTERN LOOKED LIKE A CYST,THE MOST COMMON IS LYMPHOMA.

Reference :    MEDIC ULTRASOUND case 452 : Castleman disease.

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