The Journal of Radiology Case Reports - interactive Radiology case reports and Radiology review articles

Journal of Radiology Case Reports

Adult abdominal Burkitt lymphoma with isolated peritoneal involvement

Case Report

Catarina Oliveira1*, Hugo Matos1, Paula Serra2, Rui Catarino1, Amélia Estevão1

Radiology Case. 2014 Jan; 8(1):27-33 :: DOI: 10.3941/jrcr.v8i1.1400

Cite this paper

1. Medical Imaging Department and Faculty of Medicine, University Hospital of Coimbra, Portugal
2. Pathology Department, General Hospital, University Hospital of Coimbra, Portugal

Bookmark and Share


         



  ABSTRACT
Top
Abstract
Case Report
Discussion
Teaching Point
Figures
References
Abbreviations
More Images
Your opinion

Burkitt lymphoma is a fast-growing high grade B-cell neoplasm that rarely affects adults. Three clinical variants are described in the World Health Organization classification: endemic, sporadic, and immunodeficiency-associated. The non-endemic form typically presents as an abdominal mass in children. Symptoms usually occur due to mass effect or direct intestinal involvement. We describe a very unusual presentation of a sporadic Burkitt lymphoma case in a 61-year-old male with diffuse peritoneal and omental involvement, without lymphadenopathies, mimicking peritoneal carcinomatosis.








  CASE REPORT
Top
Abstract
Case Report
Discussion
Teaching Point
Figures
References
Abbreviations
More Images
Your opinion

A 61-year-old Caucasian male, with no relevant medical or surgical history, presented to the emergency department with progressive increase in abdominal volume and loss of weight in the past 3 days. No other clinical signs were reported. There was no history of fever. He denied nausea, vomiting or changes in bowel habits. No hepatic, renal or cardiovascular disease history was reported.

Physical examination: The patient was somnolent, but stable, with no signs of respiratory distress. The only finding was the presence of a large palpable mass occupying the upper quadrants of the abdomen. Abdominal rebound and rigidity were absent and bowel sounds were normal.

Laboratorial findings: hematocrit was normal, WBC count was 10,1 x 10^3/uL (N: 4-10 x 10^3uL), total bilirubin was 22umol/L (N: <22umol/L); alanine aminotransferase was 47U/L (N: 13-69U/L); alkaline phosphatase was 93U/L (N: 38-126U/L), creatinine was 93,5 umol/L (N: 58,0 - 110,0 umol/L). There was a slight elevation in aspartate aminotransferase: 76U/L (N: 15-46U /L) and urea: 10,5 mmol/L (N: 3,2-7,1 mmol/L) and a very high lactate dehydrogenase (LDH): 2198 U/L (N: 313.0 - 618.0 U/L).

There was a high suspicion of abdominal neoplasm due to these findings.

Imaging workup: Abdominal ultrasound (US) revealed moderate anechoic effusion filling all the peritoneal recesses and diffuse nodular heterogeneous thickening of the abdominal wall (Fig. 1 Preview this figure

Figure 1: Ultrasound
Sixty-one-year-old male with Burkitt lymphoma. Upper abdominal ultrasound using a curve probe (3-5 MHz). a) Longitudinal scan of the right hypochondrium shows peritoneal anechoic effusion in the Morison pouch (asterisk); b) Transversal scan of the epigastric region demonstrates heterogeneous nodular thickening of the anterior abdominal wall.
). The liver had a regular contour and homogeneous parenchyma. They were no significant findings in the gallbladder, spleen, and kidneys. No evident bowel dilatation or mural thickening was noted.

A plain and contrast enhanced computed tomography (CT) of the thorax, abdomen and pelvis, with oral contrast, was subsequently performed. The abdominal and pelvic study revealed diffuse nodular peritoneal thickening, with heterogeneous enhancement. Peritoneal thickening was more prominent in the lesser sac, which was also filled with fluid (Fig. 2 Preview this figure
Figure 2: Computed Tomography
Sixty-one-year-old male with Burkitt lymphoma. Plain and contrast enhanced CT of the abdomen (Scanner: Multidetector CT Philips Brilliance 16- slices®. Protocol: 250mAs, 120kV, 5mm slice thickness, 100ml iobitridol Xenetix® (350 mg Iodine/ml)).a) Axial plain CT shows diffuse nodular thickening of the peritoneum in the lesser sac (arrows). At the same level, axial contrast enhanced CT in the arterial b) and portal phase c) shows heterogeneous enhancement of the nodular peritoneal thickening (arrows); d) Axial contrast enhanced CT, at a more cranial level, demonstrates low attenuation free peritoneal effusion also filling the lesser sac (asterisk).
a-2d). Diffuse thickening of the greater omentum was also noted, resulting in a mass-like appearance with caking effect; no intestinal involvement was noted. Free low attenuation peritoneal effusion was also present (Fig. 3 Preview this figure
Figure 3: Computed Tomography
Sixty-one-year-old male with Burkitt lymphoma. Axial and plain contrast enhanced CT of the abdomen (Scanner: Multidetector CT Philips Brilliance 16- slices®. Protocol: 250mAs, 120kV, 5mm slice thickness, 100ml iobitridol Xenetix® (350 mg Iodine/ml)); a) Plain axial CT demonstrates diffuse thickening of the greater omentum resulting in a large mass-like appearance with caking effect (arrows). Contrast enhanced CT in the arterial phase at different levels b), c) and d) reveals heterogeneous enhancement and a diffuse vascular net (arrows).
and Fig. 4 Preview this figure
Figure 4: Computed Tomography
Sixty-one-year-old male with Burkitt lymphoma. Multiplanar reconstruction in the coronal a) and sagittal b) plan of a contrast enhanced CT of the abdomen and pelvis in the portal phase (Scanner: Multidetector CT Philips Brilliance 16- slices®. Protocol: 250mAs, 120kV, 5mm slice thickness, 100ml iobitridol Xenetix® (350 mg Iodine/ml)). There is a diffuse nodular heterogeneous thickening of the peritoneum (arrows) and low attenuation free peritoneal effusion; no enlarged lymph nodes were noted.
). There was no evidence of lymph node enlargement along the retroperitoneal, mesenteric or pelvic regions. The thoracic study revealed a small right pleural effusion, without pleural thickening. Pulmonary parenchyma had no changes. No other prominent findings were evident on the CT.

Considering these changes, there was a high suspicion of metastatic disease due to a gastrointestinal tract neoplasm.

The patient underwent an upper digestive endoscopy, which showed small esophageal varices, antral erosive gastritis, and decreased gastric distension probably related to extrinsic compression. Biopsies were performed, revealing only chronic antral gastritis with mild atrophy and complete intestinal metaplasia (without dysplasia). Mild Helicobacter pylori colonization was also present.

Later laboratorial investigations included some tumor markers: carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA 19.9), alpha-fetoprotein (AFP) and prostate-specific antigen (PSA), all within normal levels. Serological HIV (type 1 and 2) study was also negative.

A diagnostic laparotomy was performed, permitting the nodular peritoneal thickening biopsy, as well as the removal of a great gastric curvature ganglion for histological evaluation.

Pathologic evaluation: Microscopic examination of the biopsy revealed a malignant neoplasm with diffuse growth pattern. The neoplastic cells were of intermediate size, with round nuclei and small nucleoli. Several mitotic and apoptotic figures were identified, as well as numerous macrophages containing cellular debris, giving a `starry sky` appearance (Fig. 5 Preview this figure
Figure 5: Microscopic pathology
Hematoxylin & Eosin high power view (x400) of the peritoneal thickening biopsy shows sheets and cords of intermediate size lymphocytes. They have round nuclei and small nucleoli with high nuclear/cytoplasm ratio, hyperchromasia and apoptotic bodies. Several mitotic figures were identified as well as numerous macrophages containing cellular debris giving `starry sky` appearance, a typical feature of Burkitt lymphoma.
). Neoplastic cells were strongly immunoreactive for LCA and CD20; BCL6 was positive in about 50% and Ki67 in more than 90% of neoplastic cells (Fig. 6 Preview this figure
Figure 6: Microscopic pathology
Immunorreactivity high power view (x400) of the peritoneal thickening biopsy. a) Using antibody against CD20 - there was intense positive immunoreactivity; b) Using antibody against BCL6 - positive immunorreactivity occurred in about 50% of the neoplastic cells c) Using antibody against Ki-67 - there is intense positive immunorreactivity in the neoplastic cells (expressed in >90%), characteristic features of Burkitt lymphoma.
). These features were consistent with the diagnosis of Burkitt lymphoma.

The greater curvature ganglion examination showed edema, sinus histiocytosis, and perinodal adipose tissue infiltration by the neoplastic cells described above.

A bone marrow biopsy was performed for staging, revealing no involvement by the neoplastic cells.

Cytostatic treatment with COPADM protocol was initialized with good clinical and analytic response. The patient was then transferred to the Department of Hematology of a local oncologic institute.

  DISCUSSION
Top
Abstract
Case Report
Discussion
Teaching Point
Figures
References
Abbreviations
More Images
Your opinion

Burkitt lymphoma (Table 1) is a very aggressive B-cell neoplasm. The endemic form occurs in African children, usually involving the jaw and other facial bones. The immunodeficiency-associated form usually occurs in patients with HIV/AIDS and commonly presents as diffuse lymphadenopathy. Sporadic Burkitt lymphoma occurs worldwide (usually in children and young adults), being more frequent in males [1]. It accounts only for 1%-2% of lymphoma in adults in the U.S. and Western Europe [1,2].

Clinical presentation depends on the site of involvement, the most common being the abdomen.

Mesenteric and retroperitoneal lymph node involvement commonly presents as abdominal and pelvic masses [4,5]. These masses may be large, single or multiple. Some masses may have necrotic centers containing fluid or, in rare cases, air [6,7]. Calcification of mesenteric and retroperitoneal masses has been reported in aggressive types of non-Hodgkin`s lymphoma and, specifically, in Burkitt lymphoma. Ascites is a common finding and the diagnosis of Burkitt lymphoma can often be made by paracentesis [5].

Extranodal involvement is very common, usually occurring in the gastrointestinal tract, but solid organs can also be affected, most frequently the spleen, liver, kidneys, pancreas, adrenal glands, and testes [3].

Lymphomatosis involvement of the peritoneum is not frequent, and it is usually associated with diffuse B-cell lymphoma [8,9]. CT findings include peritoneal thickening, usually in a linear rather than nodular pattern, with heterogeneous enhancement following administration of intravenous contrast. Peritoneal masses and ascites are commonly associated. Omental involvement can result in a large mass-like effect with caking or confluent nodules [9]. When diffuse peritoneal disease is present, it is usually associated with focal gastrointestinal masses and/or significant retroperitoneal or mesenteric lymphadenopathies that may be very large with a mass-like appearance [8,9]. Liver and spleen enlargement can also be concomitant findings. Isolated peritoneal involvement is rare, and it has been described only in young adults and children [10,11].

Differential diagnosis (Table 2):
1) Peritoneal carcinomatosis: This is by far the most common diagnosis of diffuse peritoneal involvement, especially in older patients. It usually results from the secondary spread of primary mucinous tumors - ovarian and colonic origin being the most common. In children and adolescents, desmoplastic small round cell tumor is the most frequent primary origin [4]. Imaging findings are nonspecific. Neoplastic peritoneal involvement presents at CT as a soft-tissue process (tumorous or infiltrative) that may have prominent enhancement, with or without associated ascites. Omental involvement is frequent. Some authors claim that an irregular outer contour of the infiltrated omentum is more suggestive of carcinomatosis [12]. Cystic or fat component, necrosis or calcifications may be additional findings. A primary known neoplasm also favors the diagnosis. In the lack of known neoplasm, an occult gastrointestinal, ovarian or other organ neoplasm should be initially favored, especially in older patients [13].
2) Malignant peritoneal mesothelioma. This is a very rare entity. In contrast to pleural mesothelioma, not all of the cases of peritoneal mesothelioma have a history of significant asbestos exposure. They are two major patterns of disease: a "dry" appearance, consisting in peritoneal masses that may be confluent, and a "wet" appearance, consisting of ascites and nodular or diffuse peritoneal thickening. Scalloping of adjacent abdominal organs may be found. Calcifications are uncommon [13].
3) Tuberculous peritonitis can also mimic the tumoral pattern of peritoneal involvement and should be considered, especially if there is a clinical suspicion. There are different patterns of disease described according to the amount of peritoneal fluid [14]. Peritoneal fluid usually is heterogeneous with multiple septa and loculations. On CT, peritoneal effusion typically has high attenuation values (25-45 HU). Diffuse peritoneal thickening usually has a smoother and more regular contour. It may also have a fine nodular aspect with tiny nodules (less than 5 mm). Omental involvement may have a smudge or cake appearance. Lymphadenopathies are commonly seen; enhancement varies with the degree of caseation, but peripheral enhancement with a low-attenuation center is the most characteristic pattern [14].

Even though CT findings of diffuse peritoneal and omental lymphomatosis are undistinguishable from those seen in other etiologies, non-loculated ascites and enlarged lymph nodes have been described by some authors as helpful differential signs [9].

Burkitt lymphoma isn`t a prevalent cause of peritoneal and omental disease, but its accurate diagnosis is of utmost importance, regarding its non-surgical treatment [9]. It has a high responsive rate (>70%) to current chemotherapy protocols [1]. Despite the importance of noninvasive imaging techniques, definitive diagnosis always requires histological evaluation, peripheral blood analysis and other laboratory tests [3].

We present a very unusual case of Burkitt lymphoma with isolated peritoneal involvement. Neither enlarged lymph nodes nor other extranodal involvement were noted. There was also a very profuse involvement of the omentum, causing "omental cake" appearance, an imaging finding not yet described in the adult population for isolated lymphoma involvement. The patient`s age is also a very uncommon feature: an older patient (61 years old), with no immunocompromised status, making lymphoma diagnosis less likely and peritoneal carcinomatosis more probable.

  TEACHING POINT
Top
Abstract
Case Report
Discussion
Teaching Point
Figures
References
Abbreviations
More Images
Your opinion

When diffuse peritoneal disease is present in an adult, peritoneal Burkitt lymphoma can mimic peritoneal carcinomatosis and should be included in the differential diagnosis even in the absence of enlarged lymph nodes.








  FIGURES
Top
Abstract
Case Report
Discussion
Teaching Point
Figures
References
Abbreviations
More Images
Your opinion

Display figure 1 in original size

Figure 1: Sixty-one-year-old male with Burkitt lymphoma. Upper abdominal ultrasound using a curve probe (3-5 MHz). a) Longitudinal scan of the right hypochondrium shows peritoneal anechoic effusion in the Morison pouch (asterisk); b) Transversal scan of the epigastric region demonstrates heterogeneous nodular thickening of the anterior abdominal wall.

Figure 1: Ultrasound (Open in original size)
Sixty-one-year-old male with Burkitt lymphoma. Upper abdominal ultrasound using a curve probe (3-5 MHz). a) Longitudinal scan of the right hypochondrium shows peritoneal anechoic effusion in the Morison pouch (asterisk); b) Transversal scan of the epigastric region demonstrates heterogeneous nodular thickening of the anterior abdominal wall.

Back Back


Display figure 2 in original size
Figure 2: Sixty-one-year-old male with Burkitt lymphoma. Plain and contrast enhanced CT of the abdomen (Scanner: Multidetector CT Philips Brilliance 16- slices®. Protocol: 250mAs, 120kV, 5mm slice thickness, 100ml iobitridol Xenetix® (350 mg Iodine/ml)).a) Axial plain CT shows diffuse nodular thickening of the peritoneum in the lesser sac (arrows). At the same level, axial contrast enhanced CT in the arterial b) and portal phase c) shows heterogeneous enhancement of the nodular peritoneal thickening (arrows); d) Axial contrast enhanced CT, at a more cranial level, demonstrates low attenuation free peritoneal effusion also filling the lesser sac (asterisk).

Figure 2: Computed Tomography (Open in original size)
Sixty-one-year-old male with Burkitt lymphoma. Plain and contrast enhanced CT of the abdomen (Scanner: Multidetector CT Philips Brilliance 16- slices®. Protocol: 250mAs, 120kV, 5mm slice thickness, 100ml iobitridol Xenetix® (350 mg Iodine/ml)).a) Axial plain CT shows diffuse nodular thickening of the peritoneum in the lesser sac (arrows). At the same level, axial contrast enhanced CT in the arterial b) and portal phase c) shows heterogeneous enhancement of the nodular peritoneal thickening (arrows); d) Axial contrast enhanced CT, at a more cranial level, demonstrates low attenuation free peritoneal effusion also filling the lesser sac (asterisk).

Back Back


Display figure 3 in original size
Figure 3: Sixty-one-year-old male with Burkitt lymphoma. Axial and plain contrast enhanced CT of the abdomen (Scanner: Multidetector CT Philips Brilliance 16- slices®. Protocol: 250mAs, 120kV, 5mm slice thickness, 100ml iobitridol Xenetix® (350 mg Iodine/ml)); a) Plain axial CT demonstrates diffuse thickening of the greater omentum resulting in a large mass-like appearance with caking effect (arrows). Contrast enhanced CT in the arterial phase at different levels b), c) and d) reveals heterogeneous enhancement and a diffuse vascular net (arrows).

Figure 3: Computed Tomography (Open in original size)
Sixty-one-year-old male with Burkitt lymphoma. Axial and plain contrast enhanced CT of the abdomen (Scanner: Multidetector CT Philips Brilliance 16- slices®. Protocol: 250mAs, 120kV, 5mm slice thickness, 100ml iobitridol Xenetix® (350 mg Iodine/ml)); a) Plain axial CT demonstrates diffuse thickening of the greater omentum resulting in a large mass-like appearance with caking effect (arrows). Contrast enhanced CT in the arterial phase at different levels b), c) and d) reveals heterogeneous enhancement and a diffuse vascular net (arrows).

Back Back


Display figure 4 in original size
Figure 4: Sixty-one-year-old male with Burkitt lymphoma. Multiplanar reconstruction in the coronal a) and sagittal b) plan of a contrast enhanced CT of the abdomen and pelvis in the portal phase (Scanner: Multidetector CT Philips Brilliance 16- slices®. Protocol: 250mAs, 120kV, 5mm slice thickness, 100ml iobitridol Xenetix® (350 mg Iodine/ml)). There is a diffuse nodular heterogeneous thickening of the peritoneum (arrows) and low attenuation free peritoneal effusion; no enlarged lymph nodes were noted.

Figure 4: Computed Tomography (Open in original size)
Sixty-one-year-old male with Burkitt lymphoma. Multiplanar reconstruction in the coronal a) and sagittal b) plan of a contrast enhanced CT of the abdomen and pelvis in the portal phase (Scanner: Multidetector CT Philips Brilliance 16- slices®. Protocol: 250mAs, 120kV, 5mm slice thickness, 100ml iobitridol Xenetix® (350 mg Iodine/ml)). There is a diffuse nodular heterogeneous thickening of the peritoneum (arrows) and low attenuation free peritoneal effusion; no enlarged lymph nodes were noted.

Back Back


Display figure 5 in original size
Figure 5: Hematoxylin & Eosin high power view (x400) of the peritoneal thickening biopsy shows sheets and cords of intermediate size lymphocytes. They have round nuclei and small nucleoli with high nuclear/cytoplasm ratio, hyperchromasia and apoptotic bodies. Several mitotic figures were identified as well as numerous macrophages containing cellular debris giving `starry sky` appearance, a typical feature of Burkitt lymphoma.

Figure 5: Microscopic pathology (Open in original size)
Hematoxylin & Eosin high power view (x400) of the peritoneal thickening biopsy shows sheets and cords of intermediate size lymphocytes. They have round nuclei and small nucleoli with high nuclear/cytoplasm ratio, hyperchromasia and apoptotic bodies. Several mitotic figures were identified as well as numerous macrophages containing cellular debris giving `starry sky` appearance, a typical feature of Burkitt lymphoma.

Back Back


Display figure 6 in original size
Figure 6: Immunorreactivity high power view (x400) of the peritoneal thickening biopsy. a) Using antibody against CD20 - there was intense positive immunoreactivity; b) Using antibody against BCL6 - positive immunorreactivity occurred in about 50% of the neoplastic cells c) Using antibody against Ki-67 - there is intense positive immunorreactivity in the neoplastic cells (expressed in >90%), characteristic features of Burkitt lymphoma.

Figure 6: Microscopic pathology (Open in original size)
Immunorreactivity high power view (x400) of the peritoneal thickening biopsy. a) Using antibody against CD20 - there was intense positive immunoreactivity; b) Using antibody against BCL6 - positive immunorreactivity occurred in about 50% of the neoplastic cells c) Using antibody against Ki-67 - there is intense positive immunorreactivity in the neoplastic cells (expressed in >90%), characteristic features of Burkitt lymphoma.

Back Back


Display figure 7 in original size
Figure 7: Summary table of key findings in Sporadic Burkitt Lymphoma

Figure 7: Table (Open in original size)
Summary table of key findings in Sporadic Burkitt Lymphoma

Back Back


Display figure 8 in original size
Figure 8: Differential diagnosis table for diffuse peritoneal disease

Figure 8: Table (Open in original size)
Differential diagnosis table for diffuse peritoneal disease

Back Back


  REFERENCES
Top
Abstract
Case Report
Discussion
Teaching Point
Figures
References
Abbreviations
More Images
Your opinion



1. Ferry JA. Burkitt`s lymphoma: clinicopathologic features and differential diagnosis. Oncologist 2006 Apr; 11(4):375-83 Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine

Back Back

2. Blum KA, Lozanski G, Byrd JC. Adult Burkitt leukemia and lymphoma. Blood 2004 Nov 15;104(10):3009-20 Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine

Back Back

4. Dunnick NR, Reaman GH, Head GL, Shawker TH, Ziegler JL. Radiographic manifestations of Burkitt`s lymphoma in American patients. AJR Am J Roentgenol 1979 Jan;132(1):1-6 Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine

Back Back

5. Biko DM, Anupindi SA, Hernandez A, Kersun L, Bellah R. Childhood Burkitt lymphoma: abdominal and pelvic imaging findings. AJR Am J Roentgenol 2009 May;192(5):1304-15 Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine

Back Back

6. Fishman EK, Kuhlman JE, Jones RJ. Radiographics. CT of lymphoma: spectrum of disease 1991 Jul;11(4):647-69 Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine

Back Back

7. Sheth S, Horton KM, Garland MR, Fishman EK. Mesenteric neoplasms: CT appearances of primary and secondary tumors and differential diagnosis. Radiographics 2003 Mar-Apr;23(2):457-73; quiz 535-6 Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine

Back Back

8. Kim Y, Cho O, Song S, Lee H, Rhim H, Koh B. Peritoneal lymphomatosis: CT findings. Abdom Imaging 1998 Jan-Feb; 23(1):87-90 Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine

Back Back

9. Karaosmanoglu D, Karcaaltincaba M, Oguz B, Akata D, Ozmen M, Akhan O. CT findings of lymphoma with peritoneal, omental and mesenteric involvement: peritoneal lymphomatosis. Eur J Radiol 2009 Aug; 71(2):313-7 Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine

Back Back

10. Toma P, Granata C, Rossi A, Garaventa A. Multimodality imaging of Hodgkin disease and non-Hodgkin lymphomas in children. Radiographics 2007 Sep-Oct;27 (5):1335-54 Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine

Back Back

11. Wong S, Sanchez TR, Swischuk LE, Huang FS. Diffuse peritoneal lymphomatosis: atypical presentation of Burkitt lymphoma. Pediatr Radiol 2009 Mar;39(3):274-6 Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine

Back Back

12. Yoo E, Kim J H, Kim MJ, Yu JS, Chung JJ, Yoo HS, Kim KW. Greater and Lesser Omenta: Normal Anatomy and Pathologic Processes. RadioGraphics 2007; 27:707-720 Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine

Back Back

13. Pickhardt PJ, Bhalla S. Primary Neoplasms of Peritoneal and Subperitoneal Origin: CT Findings. RadioGraphics 2005; 25:983-995 Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine

Back Back

14. Vanhoenacker FM, Backer AI, Op de Beeck B, Maes M, Van Altena R, Van Beckevoort D, Kersemans P, De Schepper, AM. Imaging of gastrointestinal and abdominal tuberculosis. Eur Radiol (2004) 14:E103-E115 Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine

Back Back

  ABBREVIATIONS
Top
Abstract
Case Report
Discussion
Teaching Point
Figures
References
Abbreviations
More Images
Your opinion

AFP = Alpha-fetoprotein
AIDS = Acquired immunodeficiency syndrome.
BCL6 = B-cell CLL/lymphoma 6
CA 19.9 = Carbohydrate antigen 19-9
CD20 = Cluster of differentiation 19
CEA = Carcinoembryonic antigen
COPADM = Cyclophosphamide, Vincristine and Methylprednisolone
CT = Computed tomography
HIV = Human immunodeficiency virus
Ki67 = Antigen KI-67
LCA = Leukocyte common antigen
LDH = Lactate dehydrogenase
PSA = Prostate-specific antigen
US = Ultrasound
WBC = White blood cell









  MORE IMAGES
Top
Abstract
Case Report
Discussion
Teaching Point
Figures
References
Abbreviations
More Images
Your opinion

Find more cases and images for:

Burkitt lymphoma at Radiolopolis or Radiology Search
Multidetector computed tomography at Radiolopolis or Radiology Search
Omental caking at Radiolopolis or Radiology Search
Peritoneal neoplasm at Radiolopolis or Radiology Search









  YOUR OPINION
Top
Abstract
Case Report
Discussion
Teaching Point
Figures
References
Abbreviations
More Images
Your opinion

Let us know what you think!












Cite this paper


©2020 Journal of Radiology Case Reports :: www.RadiologyCases.com :: Published by EduRad