Pseudomyxoma peritonei differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Nima Nasiri, M.D.[2]

Overview

Pseudomyxoma peritonei must be differentiated from peritoneal carcinomatosis without mucinous ascites, peritoneal sarcomatosis, and tuberculosis peritonitis.

Differential Diagnosis

Differentiating pseudomyxoma peritonei from other diseases

Diseases Clinical manifestations Para-clinical findings Gold standard Additional findings
Symptoms Signs
Lab Findings Imaging Histopathology
Symptom Constitutional symptoms Physical exam Other lab values CT Scan Ultrasound
Pseudomyxoma peritonei[1][2][3][4]
  • Non specific
  • Low-attenuation
  • The echoes within pseudomyxoma peritonei are not mobile.
  • Echogenic septations within the gelatinous ascites.
  • Scalloping of the hepatic and splenic margins
  • Depending on WHO classification, whether it's low or high grade with cellular atypia or acellular mucin. ( DPAM, PMCA)
Peritoneal carcinomatosis without mucinous ascites[5][6][7]
  • Echoes are mobile
Peritoneal sarcomatosis[8][9]
  • Heterogeneous bulky masses
  • Hypervascularity with or without hemoperitoneum
  • Variable presence of ascites.
Lymphomatosis[10][11][12][8] +
Tuberculosis Peritonitis[13][14] +
Endometriosis[15][16][17][18][19]
  • Menstrual cramps
  • Heavy menstrual periods
  • Pain during or after sex
  • Thomsen-Friedenreich (T) antigen (Gal beta1-3GalNAc)
Sclerosing encapsulating peritonitis[20][21][22][23]
  • Increased CRP level
  • Fibrin-fibrin degradation product
Gliomatosis Peritonei[24][25][26][27][28][29]
Osseous metaplasia[8][30]
Splenosis[8][31][32][33][34]
  • Lesions are typically multiple, small, reddish-brown nodules that range in size from a few millimeters to 7 cm
Melanosis[35][36][37][38][39]
  • Majority of cases are asymptomatic
  • Majority have normal lab values
Inflammatory Pseudotumor[40]

References

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  39. . doi:10.5114/pjp.2015.549. Missing or empty |title= (help)
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