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Abstract：
Peritoneal lymphomatosis (PL) is a rare lymphoma-associated condition defined as the dissemination of lymphoma cells in the peritoneum. An 82-year-old man presented with abdominal pain, heartburn, and high fever. Radiological findings, including positron emission tomography-computed tomography (PET-CT), and gastrointestinal fiberscopy, showed diffuse thickening of the peritoneum, omentum, and mesentery; however, no lymphadenopathy, hepatosplenomegaly, or gastrointestinal lesions were observed. Under suspicion of peritonitis carcinomatosa of unknown origin, exploratory laparoscopy was performed that revealed multiple white nodules and masses on the surfaces of the peritoneum, mesentery, and intestinal serosa. The histopathological and cytogenetic findings of the peritoneum revealed high-grade B-cell lymphoma, not otherwise specified, and a gain of MYC by fluorescence in-situ hybridization. The patient was treated with two cycles of R-CHOP therapy, followed by six cycles of dose-adjusted EPOCH-R therapy, and a complete metabolic response was confirmed by PET-CT. Since there are no specific radiological findings to confirm the diagnosis of PL, a histopathological diagnosis is usually required. Most PL exhibit an aggressive lymphoma phenotype and can be cured by appropriate chemotherapy. Therefore, early diagnosis and treatment are desirable.
摘要：
腹膜淋巴瘤病（PL）是一种罕见的淋巴瘤相关疾病，定义为淋巴瘤细胞在腹膜中的扩散。一名82岁的男子出现腹痛，胃灼热,高烧。放射学发现,包括正电子发射断层扫描-计算机断层扫描（PET-CT），和胃肠纤维镜检查，显示腹膜弥漫性增厚，网膜,和肠系膜；然而，没有淋巴结病,肝脾肿大,或观察到胃肠道病变。怀疑有不明原因的癌性腹膜炎,进行探查性腹腔镜检查，发现腹膜表面有多个白色结节和肿块，肠系膜,和肠道浆膜.腹膜的组织病理学和细胞遗传学发现揭示了高级B细胞淋巴瘤，未指定，并通过荧光原位杂交获得MYC。患者接受了两个周期的R-CHOP治疗，随后是六个周期的剂量调整的EPOCH-R治疗，PET-CT证实了完整的代谢反应。由于没有特定的放射学发现来确认PL的诊断，通常需要进行组织病理学诊断。大多数PL表现出侵袭性淋巴瘤表型，可以通过适当的化疗治愈。因此,早期诊断和治疗是可取的。
