Non-Hodgkin lymphoma mimics retroperitoneal fibrosis

Wan, Ningxin; Jiao, Yang

doi:10.1136/bcr-2013-010433

Cited by 11 publications

(9 citation statements)

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“…[ 14 ] Enlarged lymph nodes resulting from these two diseases can be misdiagnosed because of atypical, diverse, or similar symptoms in clinics. [ 7 8 9 10 ] This issue is a critical consideration because the diseases are managed by relatively effective but very distinct treatments. Although biopsy is often considered as the gold standard for final diagnosis, it is usually performed after CT examination and is invasive.…”

Section: Discussionmentioning

confidence: 99%

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Differentiation of Lymphoma Presenting as Retroperitoneal Mass and Retroperitoneal Fibrosis

Zhang

Chen

et al. 2017

Chinese Medical Journal

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Background:Retroperitoneal fibrosis (RPF) and lymphoma presenting as retroperitoneal mass may closely resemble each other and misdiagnosis may occur. This study investigated the differential imaging features of RPF and lymphoma which presented as a retroperitoneal soft tissue using multidetector-row computed tomography (MDCT).Methods:The 42 consecutive patients were included in this retrospective review, including 19 RPF patients (45.2%; including 13 males and 6 females; mean age: 56.7 ± 6.2 years) and 23 patients with lymphoma (54.8%; including 14 males and 9 females; mean age: 57.4 ± 12.3 years). An array of qualitative computed tomography (CT) features of lesions in 42 consecutive patients with newly diagnosed untreated RPF and lymphoma were retrospectively analyzed. The quantitative size of the lesion at the para-aortic region and attenuation in the precontrast, arterial, and portal phases were calculated in regions of interest and compared between the patients with newly diagnosed untreated RPF and with lymphoma. Receiver operating characteristic curve analysis was used to assess the potential diagnostic value of each quantitative parameter. Inter-reader concordance was also calculated.Results:Mean ages between patients with RPF and lymphoma were not significantly different (56.7 ± 6.2 years vs. 57.4 ± 12.3 years P = 0.595). Compared to those in patients with lymphoma, homogeneous enhancement (65.2% vs. 94.7%, P = 0.027) and pelvic extension (52.2% vs. 89.5%, P = 0.017) were significantly more common while the involvement of additional nodes (78.3% vs. 5.3%, P < 0.001), suprarenal extension (60.9% vs. 15.8%, P = 0.004), and aortic displacement (43.5% vs. 5.3%, P = 0.006) were significantly less common in patients with RPF. Lesion size at the para-aorta was significantly greater in patients with lymphoma, compared with RPF patients (3.9 ± 1.2 cm vs. 1.8 ± 0.6 cm; P < 0.001). The attenuation values in three phases were not significantly different between patients with RPF and lymphoma. Inter-reader concordance for subjective features ranged from very good to excellent (range: 85.7–100.0%).Conclusions:This study showed that MDCT can help differentiate between untreated RPF and lymphoma on the basis of qualitative CT features and lesion sizes. Differentiating RPF from lymphoma on the basis of attenuation values in the precontrast, arterial, and portal phases was difficult to accomplish.

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Section: Discussionmentioning

confidence: 99%

“…[ 6 ] In such instances, RPF and lymphoma may closely resemble each other and misdiagnosis may occur. [ 7 8 9 10 ] Because the treatment strategies and progress of RPF and lymphoma differ, differentiating between these diseases is crucial.…”

Section: Introductionmentioning

confidence: 99%

Differentiation of Lymphoma Presenting as Retroperitoneal Mass and Retroperitoneal Fibrosis

Zhang

Chen

et al. 2017

Chinese Medical Journal

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“…Otro estudio sugirió que la heterogeneidad en la captación del contraste por la masa retroperitoneal, el desplazamiento de la aorta hacia anterior y la existencia de adenopatías aumentan la probabilidad de linfoma 42 . Se ha recomendado que se efectúe biopsia del tejido retroperitoneal para asegurar el diagnóstico, la que puede efectuarse en forma mínimamente invasiva con una aguja guiada bajo visión radiológica o con cirugía abierta 43 . La apariencia macroscópica del retroperitoneo durante la cirugía frecuentemente no permite distinguir si la FRP es benigna o maligna 10 .…”

Section: Discussionunclassified

Fibrosis retroperitoneal asociada a neoplasias malignas: Serie de casos clínicos

2014

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“…Conversely, in 2013 Wan et al published a case report regarding a patient with lymphoedema and obstructive nephropathy from a large retroperitoneal mass who was originally diagnosed with retroperitoneal fibrosis based on clinical suspicion and imaging. Subsequently, a CT guided biopsy was obtained which revealed non-Hodgkin's lymphoma ( Wan and Jiao, 2013 ). These cases highlight the fact that while imaging and clinical features may raise suspicion for a retroperitoneal inflammatory condition, a biopsy must be obtained to ensure diagnosis.…”

Section: Commentmentioning

confidence: 99%