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• W4313201236 abstract "Peritoneal lymphomatosis is uncommon and exclusively found in patients with immunocompromised status. Herein, we report a 5-year-old boy who presented with acute onset abdominal pain, abdominal distension, and nausea with poor appetite for 2 weeks, accompanied by a high fever (39.4 °C), fatigue, and highly elevated lactate dehydrogenase (LDH, 1199 IU/L); however, no night sweats or unexplained weight loss were noted. His physical examination showed a distended abdomen with diffuse tenderness. Subsequent abdominal ultrasonography revealed a soft tissue mass lesion in the lower right abdomen, which was indistinguishable from the bowels, and diffuse bowel wall thickening (Supplementary Fig. 1A). An additional abdominal computed tomography examination revealed ill-defined soft tissue lesions involving small bowel loops and mesentery, resulting in mild small bowel ileus and right side pleural effusion. On admission, his biochemical data showed elevated levels of uric acid (9.7 mg/dL), LDH (919 IU/L), and hypocalcemia (8.4 mg/dL), indicating tumor lysis syndrome. Subsequent laparoscopic operative findings show multiple abnormal masses on the omentum and diffuse infiltration changes on the peritoneum. Pathological diagnosis revealed Burkitt lymphoma in the peritoneum and omentum. Although the bone scan demonstrated no evidence of bone metastases, the positron emission tomography (PET) revealed peritoneal seeding in the abdominal and pelvic cavities with suspicion of bone marrow involvement in the left distal femur and left proximal tibia (Supplementary Fig. 1B). Based on the diagnosis and classification of Burkitt lymphoma stage III with risk group 3, the patient started multiagent chemotherapy, including the TPOG-NHL 2010 protocol of vincristine (1.5 mg/m2/day for 1 day), ifosfamide (800 mg/m2/day for 5 days), methotrexate (5 g/m2/day for 1 day), cytarabine (Ara-C) (150 mg/m2/day for 2 days), and etoposide (Fytosid) (100 mg/m2/day for 2 days). After completing the scheduled chemotherapy course, our outpatient department of pediatric hematology followed up with him, and no relapse of tumor was found in the 2-year follow-up period. Peritoneal lymphomatosis is a rare and aggressive tumor in children. Previously, diffuse nasopharyngeal non-Hodgkin lymphoma with Henoch–Schönlein purpura and elevated hepatitis C virus antibody levels in a girl were reported.1Hou J.Y. Liu H.C. Liang D.C. Choi Y.S. Lin C.Y. Henoch-Schönlein purpura and elevated hepatitis C virus antibody in a girl with nasopharyngeal diffuse large B-Cell lymphoma.Pediatr Neonatol. 2011; 52: 349-352Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar As in our case, the clinical presentation of abdominal distension, pain, and fever may masquerade as pyoperitoneum.2Ravindranath A. Srivastava A. Seetharaman J. Pandey R. Sarma M.S. Poddar U et al.Peritoneal lymphomatosis masquerading as Pyoperitoneum in a Teenage boy.ACG Case Rep J. 2019; 6e00116Crossref PubMed Google Scholar Sonographic studies were evaluated for the presence of peritoneal involvement, and PET/computed tomography could help in the differentiation between peritoneal carcinomatosis and peritoneal sarcomatosis3Que Y. Wang X. Sonography of peritoneal lymphomatosis: some new and different findings.Ultrasound Q. 2015; 31: 55-58Crossref PubMed Scopus (3) Google Scholar,4Cabral F.C. Krajewski K.M. Kim K.W. Ramaiya N.H. Jagannathan J.P. Peritoneal lymphomatosis: CT and PET/CT findings and how to differentiate between carcinomatosis and sarcomatosis.Cancer Imaging. 2013; 13: 162-170Crossref PubMed Scopus (45) Google Scholar. Early awareness, diagnosis, and prompt chemotherapy are crucial to good outcomes. Authors have no conflict of interests. The following is the Supplementary data to this article: Download .doc (.59 MB) Help with doc files Multimedia component 1" @default.
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• W4313201236 date "2023-05-01" @default.
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• W4313201236 title "Peritoneal lymphomatosis presented with acute intermittent abdominal pain in a child" @default.
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• W4313201236 doi "https://doi.org/10.1016/j.pedneo.2022.11.007" @default.
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