PELVIC LYMPHOMA MIMICKING POST-OP PELVIC ABSCESS, Dr LÊ VĂN TÀI

A 17yo male patient suffered from a hypogastric pain for 5 months. He entered a hospital in 3 days and went out with his retentive painful. Then he went in an another hospital and had been removed an appendiceal plastron. But he was still in pain and got a rectal hemorrhagia. So his familial doctor send him to Medic Center for a reexamination.
Ultrasound detected a 73x29mm hypoechoic pelvic mass which seemed to be a post-op abscess; but in color Doppler imaging there were vascular signals inside the mass which was  looked like a cyst. Besides there were some 10-13-20mm hypoechoic nodes into the mesentery and pelvic region. Liver, spleen and bladder were intact and no fluid into his abdomen.

MSCT showed a pelvic mass on the left side of the rectum and in adhesion to the rectum and bowel. Some nodes were  noted in the mesentery and in both 2 sides of pelvic region.

A surgical procedure was done for biopsy of the mass and making an artificial anus as an obstruction of the colon. The post-op diagnosis was a big pelvic tumor which invaded the rectum. Microscopic results with immunohistopathogic stainning presented that B cell (CD 20) positive and T cell negative. So the last diagnosis was a diffuse lymphoma with big cell of line B.

 

After going through  5 times of  chemotherapy  he had no pelvic tumor now.

 

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