B-клеточная лимфома аппендикса
Анамнез: Мужчина, 52 года. Жалобы на острые боли в правой подвздошной области, клинически- острый аппендицит.
Обсуждение/выводы:
был взят в операционную, выполнена аппендэктомия. Гистологическое и ИГХ- заключение- B-клеточная лимфома аппендикса.
"Non-Hodgkin's lymphoma of the appendix typically manifests with acute symptoms in patients who have no prior history of lymphoma. Most patients with the disease present clinically with signs and symptoms suggestive of acute appendicitis. On CT, lymphomatous infiltration of the appendix produces markedly diffuse mural soft-tissue thickening (range of diameters, 2.5-4.0 cm; mean diameter, 3.2 cm). The vermiform morphology of the appendix is usually maintained, and aneurysmal dilatation of the lumen is sometimes seen. Stranding of the periappendiceal fat seen on CT may represent superimposed inflammation or even direct lymphomatous extension. Coexisting abdominal lymphadenopathy is not seen in all patients. Although appendiceal lymphoma is rare, the characteristic CT appearance could lead to a preoperative diagnosis".
https://www.ncbi.nlm.nih.gov/pubmed/11959713/
Согласно критериев уместности ACR, КТ живота с внутривенным контрастированием при клиническом подозрении на острый аппендицит имеет 8 уместность баллов из 9 возможных (процедура, как правило, уместна).
Статьи по теме
Литература
- Guo J, Wu G, Chen X, Li X. Primary appendiceal lymphoma presenting as suspected perforated acute appendicitis: clinical, sonography and CT findings with pathologic correlation. International journal of clinical and experimental pathology. 7 (10): 7068-71. Pubmed
- Pickhardt PJ, Levy AD, Rohrmann CA, Abbondanzo SL, Kende AI. Non-Hodgkin's lymphoma of the appendix: clinical and CT findings with pathologic correlation. AJR. American journal of roentgenology. 178 (5): 1123-7. doi:10.2214/ajr.178.5.1781123 - Pubmed
- Pickhardt PJ, Levy AD, Rohrmann CA, Abbondanzo SL, Kende AI. Non-Hodgkin's lymphoma of the appendix: clinical and CT findings with pathologic correlation. AJR. American journal of roentgenology. 178 (5): 1123-7. doi:10.2214/ajr.178.5.1781123 - Pubmed
- Ting-Ying Fu, Jyh-Seng Wang, Hui-Hwa Tseng. Primary Appendiceal Lymphoma Presenting as Perforated Acute Appendicitis J Chin Med Assoc
- American College of Radiology ACR Appropriateness Criteria ACR Appropriateness Criteria