Pseudomyxoma peritonei differential diagnosis: Difference between revisions

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*Scalloping of the visceral surfaces differentiates pseudomyxoma from other causes of peritnoitis.
*Scalloping of the visceral surfaces differentiates pseudomyxoma from other causes of peritnoitis.
*Typically does not invade visceral organs or spread by lymphatic or hematogenous routes unlike mucinous carcinomatosis
*Typically does not invade visceral organs or spread by [[lymphatic]] or hematogenous routes unlike mucinous carcinomatosis
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* The echoes within pseudomyxoma peritonei are not mobile.
* The echoes within pseudomyxoma peritonei are not mobile.
* Echogenic septations within the gelatinous ascites.
* Echogenic septations within the gelatinous ascites.
* Scalloping of the hepatic and splenic margins
* Scalloping of the [[hepatic]] and splenic margins
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* Depending on WHO classification, whether it's low or high grade with cellular atypia or acellular mucin. ( DPAM, PMCA)
* Depending on [[WHO]] classification, whether it's low or high grade with cellular atypia or acellular mucin. ( DPAM, PMCA)


* Gelatinous ascites in peritoneum and visceral organs,usually underneath the right hemidiaphragm, liver.  
* Gelatinous ascites in peritoneum and [[visceral]] organs,usually underneath the right hemidiaphragm, liver.  
* Omental cake  
* Omental cake  
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** CK 20
** CK 20
** CDX2
** [[CDX2]]
** MUC2
** [[MUC2]]
** MUC5AC
** MUC5AC
|-
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Peritoneal carcinomatosis]] without mucinous ascites<ref name="pmid20656916">{{cite journal |vauthors=Winder T, Lenz HJ |title=Mucinous adenocarcinomas with intra-abdominal dissemination: a review of current therapy |journal=Oncologist |volume=15 |issue=8 |pages=836–44 |date=2010 |pmid=20656916 |pmc=3228029 |doi=10.1634/theoncologist.2010-0052 |url=}}</ref><ref name="pmid21160812">{{cite journal |vauthors=Kusamura S, Baratti D, Zaffaroni N, Villa R, Laterza B, Balestra MR, Deraco M |title=Pathophysiology and biology of peritoneal carcinomatosis |journal=World J Gastrointest Oncol |volume=2 |issue=1 |pages=12–8 |date=January 2010 |pmid=21160812 |pmc=2999153 |doi=10.4251/wjgo.v2.i1.12 |url=}}</ref><ref name="pmid24222942">{{cite journal |vauthors=Coccolini F, Gheza F, Lotti M, Virzì S, Iusco D, Ghermandi C, Melotti R, Baiocchi G, Giulini SM, Ansaloni L, Catena F |title=Peritoneal carcinomatosis |journal=World J. Gastroenterol. |volume=19 |issue=41 |pages=6979–94 |date=November 2013 |pmid=24222942 |pmc=3819534 |doi=10.3748/wjg.v19.i41.6979 |url=}}</ref>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Peritoneal carcinomatosis]] without mucinous ascites<ref name="pmid20656916">{{cite journal |vauthors=Winder T, Lenz HJ |title=Mucinous adenocarcinomas with intra-abdominal dissemination: a review of current therapy |journal=Oncologist |volume=15 |issue=8 |pages=836–44 |date=2010 |pmid=20656916 |pmc=3228029 |doi=10.1634/theoncologist.2010-0052 |url=}}</ref><ref name="pmid21160812">{{cite journal |vauthors=Kusamura S, Baratti D, Zaffaroni N, Villa R, Laterza B, Balestra MR, Deraco M |title=Pathophysiology and biology of peritoneal carcinomatosis |journal=World J Gastrointest Oncol |volume=2 |issue=1 |pages=12–8 |date=January 2010 |pmid=21160812 |pmc=2999153 |doi=10.4251/wjgo.v2.i1.12 |url=}}</ref><ref name="pmid24222942">{{cite journal |vauthors=Coccolini F, Gheza F, Lotti M, Virzì S, Iusco D, Ghermandi C, Melotti R, Baiocchi G, Giulini SM, Ansaloni L, Catena F |title=Peritoneal carcinomatosis |journal=World J. Gastroenterol. |volume=19 |issue=41 |pages=6979–94 |date=November 2013 |pmid=24222942 |pmc=3819534 |doi=10.3748/wjg.v19.i41.6979 |url=}}</ref>
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* Abdominal pain
* [[Abdominal pain]]


* Abdominal distention
* [[Abdominal distention]]
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* Abdominal distention
* [[Abdominal distention]]


* Abdominal tenderness
* [[Abdominal tenderness]]
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* Positive cytology indicating malignant ascites on paracenthesis.  
* Positive [[cytology]] indicating malignant ascites on [[paracentesis]].  
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*[[Pleural effusion]] and/or masses in chest
*[[Pleural effusion]] and/or masses in chest


*Mesenteric or retroperitoneal lymphadenopathy
*Mesenteric or [[retroperitoneal]] [[lymphadenopathy]]
*[[Omental]] caking, and invasion into parenchymal organs
*[[Omental]] caking, and invasion into parenchymal organs
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* Echoes are mobile
* Echoes are mobile


* No scalloping of visceral organs.
* No scalloping of [[visceral]] organs.


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* Depending on primary tumor origin ( colorectal,ovary, appendix)
* Depending on primary tumor origin ( [[colorectal]],ovary, appendix)
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* Laparascopy/laparatomy tissue sampling   
* Laparascopy/laparatomy tissue sampling   
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* Immunohistochemistry
* Immunohistochemistry
** CEA
** [[CEA]]
** CA 19-9
** [[CA 19-9]]
** CDX2
** CDX2
** MUC2
** [[MUC2]]
** MUC5AC
** MUC5AC
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*  
*  
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* Neutrophilia
* [[Neutrophilia]]
* Reduced hemoglobin
* Reduced [[hemoglobin]]
* Lymphopenia
* [[Lymphopenia]]
* Thrombocytosis
* [[Thrombocytosis]]
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* Heterogeneous bulky masses  
* Heterogeneous bulky masses  


* Hypervascularity with or without hemoperitoneum  
* Hypervascularity with or without [[hemoperitoneum]]
* Variable presence of ascites.
* Variable presence of ascites.
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* Soft-tissue implants along the peritoneum
* Soft-tissue implants along the peritoneum


* Dense fibrotic sarcoma mass
* Dense fibrotic [[sarcoma]] mass
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* CT-guided percutaneous tissue biopsy
* CT-guided percutaneous tissue [[biopsy]]
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* Associated conditions:
* Associated conditions:
** Sarcoma
** [[Sarcoma]]
** gastrointestinal stromal tumors (GISTs)
** [[gastrointestinal stromal tumor]]<nowiki/>s (GISTs)
** Liposarcomas,  
** [[Liposarcoma|Liposarcomas]],  
** Leiomyosarcomas.
** [[Leiomyosarcoma]]<nowiki/>s.


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| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Lymphomatosis cerebri|Lymphomatosis]]<ref name="pmid19114331">{{cite journal |vauthors=Weng SC, Wu CY |title=Lymphoma presenting as peritoneal lymphomatosis with ascites |journal=J Chin Med Assoc |volume=71 |issue=12 |pages=646–50 |date=December 2008 |pmid=19114331 |doi=10.1016/S1726-4901(09)70009-7 |url=}}</ref><ref name="pmid14988144">{{cite journal |vauthors=Horger M, Müller-Schimpfle M, Yirkin I, Wehrmann M, Claussen CD |title=Extensive peritoneal and omental lymphomatosis with raised CA 125 mimicking carcinomatosis: CT and intraoperative findings |journal=Br J Radiol |volume=77 |issue=913 |pages=71–3 |date=January 2004 |pmid=14988144 |doi=10.1259/bjr/35139284 |url=}}</ref><ref name="pmid25694630">{{cite journal |vauthors=Cunningham N, Ffrench-Constant S, Planche K, Gillmore R |title=Peritoneal lymphomatosis: a rare presentation of follicular lymphoma mimicking peritoneal carcinomatosis |journal=BMJ Case Rep |volume=2015 |issue= |pages= |date=February 2015 |pmid=25694630 |pmc=4336898 |doi=10.1136/bcr-2014-207136 |url=}}</ref><ref name="LevyShaw2009">{{cite journal|last1=Levy|first1=Angela D.|last2=Shaw|first2=Janet C.|last3=Sobin|first3=Leslie H.|title=Secondary Tumors and Tumorlike Lesions of the Peritoneal Cavity: Imaging Features with Pathologic Correlation|journal=RadioGraphics|volume=29|issue=2|year=2009|pages=347–373|issn=0271-5333|doi=10.1148/rg.292085189}}</ref>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Lymphomatosis cerebri|Lymphomatosis]]<ref name="pmid19114331">{{cite journal |vauthors=Weng SC, Wu CY |title=Lymphoma presenting as peritoneal lymphomatosis with ascites |journal=J Chin Med Assoc |volume=71 |issue=12 |pages=646–50 |date=December 2008 |pmid=19114331 |doi=10.1016/S1726-4901(09)70009-7 |url=}}</ref><ref name="pmid14988144">{{cite journal |vauthors=Horger M, Müller-Schimpfle M, Yirkin I, Wehrmann M, Claussen CD |title=Extensive peritoneal and omental lymphomatosis with raised CA 125 mimicking carcinomatosis: CT and intraoperative findings |journal=Br J Radiol |volume=77 |issue=913 |pages=71–3 |date=January 2004 |pmid=14988144 |doi=10.1259/bjr/35139284 |url=}}</ref><ref name="pmid25694630">{{cite journal |vauthors=Cunningham N, Ffrench-Constant S, Planche K, Gillmore R |title=Peritoneal lymphomatosis: a rare presentation of follicular lymphoma mimicking peritoneal carcinomatosis |journal=BMJ Case Rep |volume=2015 |issue= |pages= |date=February 2015 |pmid=25694630 |pmc=4336898 |doi=10.1136/bcr-2014-207136 |url=}}</ref><ref name="LevyShaw2009">{{cite journal|last1=Levy|first1=Angela D.|last2=Shaw|first2=Janet C.|last3=Sobin|first3=Leslie H.|title=Secondary Tumors and Tumorlike Lesions of the Peritoneal Cavity: Imaging Features with Pathologic Correlation|journal=RadioGraphics|volume=29|issue=2|year=2009|pages=347–373|issn=0271-5333|doi=10.1148/rg.292085189}}</ref>
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* Abdominal pain
* [[Abdominal pain]]


* Bloating
* [[Bloating]]


* [[Swollen lymph nodes|Swollen lymph node]]
* [[Swollen lymph nodes|Swollen lymph node]]
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*  
*  
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* Omental cake
* [[Omental]] cake


* Aneurysmal dilatation of the bowel loop with wall thickening.   
* Aneurysmal dilatation of the [[bowel]] loop with wall thickening.   
* Enlarged supraclavicular, mediastinal and para-aortic lymph nodes.   
* Enlarged supraclavicular, [[mediastinal]] and para-aortic lymph nodes.   
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* Large ascitic fluid
* Large [[ascitic]] fluid
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* Atypical lymphoid cells
* Atypical [[lymphoid]] cells
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* [[Biopsy]] and histology
* [[Biopsy]] and [[histology]]
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* Rare manifestation of lymphoma, seen most frequently with non-Hodgkin lymphoma
* Rare manifestation of [[Lymphomas|lymphoma]], seen most frequently with [[non-Hodgkin lymphoma]]


* Associated with Herpes virus 8 (HHV-8), which is also associated with Kaposi sarcoma, and Epstein-Barr virus
* Associated with [[Herpes virus|Herpes virus 8]] ([[HHV-8|HHV]]-8), which is also associated with [[Kaposi sarcoma]], and [[Epstein-Barr virus]]
* Immunohistochemistry:
* Immunohistochemistry:
** CD20
** [[CD20]]
** CD79a  
** [[CD79a]]
** CD10
** [[CD10]]
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|-
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| style="background: #DCDCDC; padding: 5px; text-align: center;" | [[Tuberculosis, pulmonary|Tuberculosis]] Peritonitis<ref name="pmid21912057">{{cite journal |vauthors=Kaya M, Kaplan MA, Isikdogan A, Celik Y |title=Differentiation of tuberculous peritonitis from peritonitis carcinomatosa without surgical intervention |journal=Saudi J Gastroenterol |volume=17 |issue=5 |pages=312–7 |date=2011 |pmid=21912057 |pmc=3178918 |doi=10.4103/1319-3767.84484 |url=}}</ref><ref name="YaparEkici1995">{{cite journal|last1=Yapar|first1=E. G.|last2=Ekici|first2=E.|last3=Karasahin|first3=E.|last4=Gökmen|first4=O.|title=Sonographic features of tuberculous peritonitis with female genital tract tuberculosis|journal=Ultrasound in Obstetrics and Gynecology|volume=6|issue=2|year=1995|pages=121–125|issn=09607692|doi=10.1046/j.1469-0705.1995.06020121.x}}</ref>   
| style="background: #DCDCDC; padding: 5px; text-align: center;" | [[Tuberculosis, pulmonary|Tuberculosis]] Peritonitis<ref name="pmid21912057">{{cite journal |vauthors=Kaya M, Kaplan MA, Isikdogan A, Celik Y |title=Differentiation of tuberculous peritonitis from peritonitis carcinomatosa without surgical intervention |journal=Saudi J Gastroenterol |volume=17 |issue=5 |pages=312–7 |date=2011 |pmid=21912057 |pmc=3178918 |doi=10.4103/1319-3767.84484 |url=}}</ref><ref name="YaparEkici1995">{{cite journal|last1=Yapar|first1=E. G.|last2=Ekici|first2=E.|last3=Karasahin|first3=E.|last4=Gökmen|first4=O.|title=Sonographic features of tuberculous peritonitis with female genital tract tuberculosis|journal=Ultrasound in Obstetrics and Gynecology|volume=6|issue=2|year=1995|pages=121–125|issn=09607692|doi=10.1046/j.1469-0705.1995.06020121.x}}</ref>   
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* Abdominal pain
* [[Abdominal pain]]
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*[[Abdominal tenderness]]
*[[Abdominal tenderness]]
*Abdominal mass or bulging of flanks
*[[Abdominal mass]] or bulging of [[flanks]]


*  
*  
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* A positive [[tuberculin skin test]]
* A positive [[tuberculin skin test]]


* Ascitic fluid will have an elevated [[white blood cell]] count with a lymphocytic predominance
* Ascitic fluid will have an elevated [[white blood cell]] count with a [[lymphocytic]] predominance
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* Miliary microabscesses in the liver or spleen  
* Miliary microabscesses in the liver or [[spleen]]


* [[Lymph nodes|lymph node]] calcification
* [[Lymph nodes|lymph node]] [[calcification]]
* Inflammatory thickening of the terminal ileum and cecum
* Inflammatory thickening of the terminal [[ileum]] and [[cecum]]


* low-attenuation lymphadenopathy
* low-attenuation [[lymphadenopathy]]
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* Ascites/loculated fluid
* Ascites/loculated fluid


* Adnexal mass
* [[Adnexal mass causes|Adnexal mass]]


* Peritoneal thickening
* Peritoneal thickening
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* Omental thickening
* Omental thickening
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* Caseating [[granuloma]] with central area of necrotic acellular debris surrounded by [[histiocytes]]
* Caseating [[granuloma]] with central area of [[necrotic]] acellular debris surrounded by [[histiocytes]]
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* Laparoscopy and peritoneal biopsy
* [[Laparoscopy]] and peritoneal biopsy
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* Immunohistochemistry
* Immunohistochemistry
** Elevated serum [[CA-125]] level
** Elevated serum [[CA-125]] level
** Normal serum [[CA 19-9]], and [[CEA]] associated with lymphocyte predominant benign ascites
** Normal serum [[CA 19-9]], and [[CEA]] associated with [[lymphocyte]] predominant benign ascites
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Endometriosis (female)|Endometriosis]]<ref name="pmid29247637">{{cite journal |vauthors=DiVasta AD, Vitonis AF, Laufer MR, Missmer SA |title=Spectrum of symptoms in women diagnosed with endometriosis during adolescence vs adulthood |journal=Am. J. Obstet. Gynecol. |volume=218 |issue=3 |pages=324.e1–324.e11 |date=March 2018 |pmid=29247637 |doi=10.1016/j.ajog.2017.12.007 |url=}}</ref><ref name="pmid11949946">Yeaman GR, Collins JE, Lang GA (March 2002). "Autoantibody responses to carbohydrate epitopes in endometriosis". Ann. N. Y. Acad. Sci. 955: 174–82, discussion 199–200, 396–406. PMID 11949946.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles></ref><ref name="pmid15980014">{{cite journal |vauthors=Kennedy S, Bergqvist A, Chapron C, D'Hooghe T, Dunselman G, Greb R, Hummelshoj L, Prentice A, Saridogan E |title=ESHRE guideline for the diagnosis and treatment of endometriosis |journal=Hum. Reprod. |volume=20 |issue=10 |pages=2698–704 |date=October 2005 |pmid=15980014 |doi=10.1093/humrep/dei135 |url=}}</ref><ref name="pmid20436318">{{cite journal |vauthors=Hsu AL, Khachikyan I, Stratton P |title=Invasive and noninvasive methods for the diagnosis of endometriosis |journal=Clin Obstet Gynecol |volume=53 |issue=2 |pages=413–9 |date=June 2010 |pmid=20436318 |pmc=2880548 |doi=10.1097/GRF.0b013e3181db7ce8 |url=}}</ref><ref name="BloskiPierson2008">{{cite journal|last1=Bloski|first1=Terri|last2=Pierson|first2=Roger|title=Endometriosis and Chronic Pelvic Pain: Unraveling the Mystery Behind this Complex Condition|journal=Nursing for Women's Health|volume=12|issue=5|year=2008|pages=382–395|issn=17514851|doi=10.1111/j.1751-486X.2008.00362.x}}</ref>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Endometriosis (female)|Endometriosis]]<ref name="pmid29247637">{{cite journal |vauthors=DiVasta AD, Vitonis AF, Laufer MR, Missmer SA |title=Spectrum of symptoms in women diagnosed with endometriosis during adolescence vs adulthood |journal=Am. J. Obstet. Gynecol. |volume=218 |issue=3 |pages=324.e1–324.e11 |date=March 2018 |pmid=29247637 |doi=10.1016/j.ajog.2017.12.007 |url=}}</ref><ref name="pmid11949946">Yeaman GR, Collins JE, Lang GA (March 2002). "Autoantibody responses to carbohydrate epitopes in endometriosis". Ann. N. Y. Acad. Sci. 955: 174–82, discussion 199–200, 396–406. PMID 11949946.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles></ref><ref name="pmid15980014">{{cite journal |vauthors=Kennedy S, Bergqvist A, Chapron C, D'Hooghe T, Dunselman G, Greb R, Hummelshoj L, Prentice A, Saridogan E |title=ESHRE guideline for the diagnosis and treatment of endometriosis |journal=Hum. Reprod. |volume=20 |issue=10 |pages=2698–704 |date=October 2005 |pmid=15980014 |doi=10.1093/humrep/dei135 |url=}}</ref><ref name="pmid20436318">{{cite journal |vauthors=Hsu AL, Khachikyan I, Stratton P |title=Invasive and noninvasive methods for the diagnosis of endometriosis |journal=Clin Obstet Gynecol |volume=53 |issue=2 |pages=413–9 |date=June 2010 |pmid=20436318 |pmc=2880548 |doi=10.1097/GRF.0b013e3181db7ce8 |url=}}</ref><ref name="BloskiPierson2008">{{cite journal|last1=Bloski|first1=Terri|last2=Pierson|first2=Roger|title=Endometriosis and Chronic Pelvic Pain: Unraveling the Mystery Behind this Complex Condition|journal=Nursing for Women's Health|volume=12|issue=5|year=2008|pages=382–395|issn=17514851|doi=10.1111/j.1751-486X.2008.00362.x}}</ref>
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* Immobile uterine
* Immobile [[uterine]]


* [[Cervical motion tenderness]]
* [[Cervical motion tenderness]]
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* Tender [[Adnexal mass causes|adnexal mass]]
* Tender [[Adnexal mass causes|adnexal mass]]


* Tender uterosacral nodularity
* Tender [[Uterosacral ligament|uterosacral]] nodularity
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* Thomsen-Friedenreich (T) antigen (Gal beta1-3GalNAc)
* Thomsen-Friedenreich (T) antigen (Gal beta1-3GalNAc)
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* CT Scan is not routinely used for diagnosing endometriosis.
* [[CT Scan]] is not routinely used for diagnosing [[endometriosis]].


*  
*  
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* Hypoechogenic linear thickening or nodules/masses
* Hypoechogenic linear thickening or nodules/masses
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* Endometrial-type glands and stroma   
* [[Endometrial]]-type glands and stroma   
* Hemosiderin-laden macrophages
* [[Hemosiderin]]-laden macrophages


* Hemorrhagic, reddish brown nodules on the surfaces of peritoneum.
* [[Hemorrhagic]], reddish brown nodules on the surfaces of peritoneum.
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* Visual inspection with [[Laparoscopy|laparascopy]]
* Visual inspection with [[Laparoscopy|laparascopy]]
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* Associated conditions:
* Associated conditions:
** Increased risk of breast cancer
** Increased risk of [[breast cancer]]
** Non-Hodgkin's lymphoma
** [[Non-Hodgkin's lymphoma]]
** Chronic pelvic pain
** Chronic pelvic pain
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Sclerosing encapsulating peritonitis]]<ref name="pmid17616031">{{cite journal |vauthors=Suh WN, Lee SK, Chang H, Hwang HJ, Hyung WJ, Park YN, Kim TI |title=Sclerosing encapsulating peritonitis (abdominal cocoon) after abdominal hysterectomy |journal=Korean J. Intern. Med. |volume=22 |issue=2 |pages=125–9 |date=June 2007 |pmid=17616031 |pmc=2687622 |doi= |url=}}</ref><ref name="pmid25217877">{{cite journal |vauthors=Al Ani AH, Al Zayani N, Najmeddine M, Jacob S, Nair S |title=Idiopathic sclerosing encapsulating peritonitis (abdominal cocoon) in adult male. A case report |journal=Int J Surg Case Rep |volume=5 |issue=10 |pages=735–8 |date=2014 |pmid=25217877 |pmc=4189066 |doi=10.1016/j.ijscr.2014.07.017 |url=}}</ref><ref name="pmid24055916">{{cite journal |vauthors=Sharma D, Nair RP, Dani T, Shetty P |title=Abdominal cocoon-A rare cause of intestinal obstruction |journal=Int J Surg Case Rep |volume=4 |issue=11 |pages=955–7 |date=2013 |pmid=24055916 |pmc=3825929 |doi=10.1016/j.ijscr.2013.08.004 |url=}}</ref><ref name="pmid27226904">{{cite journal |vauthors=Machado NO |title=Sclerosing Encapsulating Peritonitis: Review |journal=Sultan Qaboos Univ Med J |volume=16 |issue=2 |pages=e142–51 |date=May 2016 |pmid=27226904 |pmc=4868512 |doi=10.18295/squmj.2016.16.02.003 |url=}}</ref>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Sclerosing encapsulating peritonitis]]<ref name="pmid17616031">{{cite journal |vauthors=Suh WN, Lee SK, Chang H, Hwang HJ, Hyung WJ, Park YN, Kim TI |title=Sclerosing encapsulating peritonitis (abdominal cocoon) after abdominal hysterectomy |journal=Korean J. Intern. Med. |volume=22 |issue=2 |pages=125–9 |date=June 2007 |pmid=17616031 |pmc=2687622 |doi= |url=}}</ref><ref name="pmid25217877">{{cite journal |vauthors=Al Ani AH, Al Zayani N, Najmeddine M, Jacob S, Nair S |title=Idiopathic sclerosing encapsulating peritonitis (abdominal cocoon) in adult male. A case report |journal=Int J Surg Case Rep |volume=5 |issue=10 |pages=735–8 |date=2014 |pmid=25217877 |pmc=4189066 |doi=10.1016/j.ijscr.2014.07.017 |url=}}</ref><ref name="pmid24055916">{{cite journal |vauthors=Sharma D, Nair RP, Dani T, Shetty P |title=Abdominal cocoon-A rare cause of intestinal obstruction |journal=Int J Surg Case Rep |volume=4 |issue=11 |pages=955–7 |date=2013 |pmid=24055916 |pmc=3825929 |doi=10.1016/j.ijscr.2013.08.004 |url=}}</ref><ref name="pmid27226904">{{cite journal |vauthors=Machado NO |title=Sclerosing Encapsulating Peritonitis: Review |journal=Sultan Qaboos Univ Med J |volume=16 |issue=2 |pages=e142–51 |date=May 2016 |pmid=27226904 |pmc=4868512 |doi=10.18295/squmj.2016.16.02.003 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Fever  
* [[Fever]]


* Weight loss
* Weight loss


* Loss of appetite   
* [[Loss of appetite]]  
* Altered bowel movement
* Altered bowel movement


* Abdominal pain  
* [[Abdominal pain]]
| style="background: #f5F5F5; text-align: center;" |–
| style="background: #f5F5F5; text-align: center;" |–
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Line 292: Line 292:
* [[Abdominal tenderness]]
* [[Abdominal tenderness]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Increased CRP level
* Increased [[CRP]] level


* Fibrin-fibrin degradation product
* [[Fibrin Degradation Products|Fibrin]]-fibrin degradation product


* Occult blood
* [[Occult blood]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Diffusely thickened peritoneum and ascites
* Diffusely thickened [[peritoneum]] and ascites
* Small bowel may be matted within loculated fluid collections
* [[Small bowel]] may be matted within loculated fluid collections
* Encapsulated small bowel
* Encapsulated [[small bowel]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Thin echogenic strands can be seen within ascitic fluid  
* Thin echogenic strands can be seen within ascitic fluid  
* Tethered small bowel
* Tethered [[small bowel]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Dense,opaque peritoneum
* Dense,opaque peritoneum


* Progressive collagen formation with an associated chronic inflammatory infiltrate
* Progressive [[collagen]] formation with an associated [[chronic inflammatory]] infiltrate
| style="background: #F5F5F5; padding: 5px;" |
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* Histology  
* Histology  
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| style="background: #F5F5F5; padding: 5px;" |
* Most commonly in patients who undergo continuous ambulatory peritoneal dialysis. It may also be idiopathic, associated with ventriculoperitoneal shunts, liver transplantation
* Most commonly in patients who undergo continuous ambulatory [[peritoneal dialysis]]. It may also be idiopathic, associated with [[Ventriculoperitoneal shunt|ventriculoperitoneal shunts]], liver [[transplantation]]
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Gliomatosis cerebri|Gliomatosis]] Peritonei<ref name="pmid26564007">{{cite journal |vauthors=Liang L, Zhang Y, Malpica A, Ramalingam P, Euscher ED, Fuller GN, Liu J |title=Gliomatosis peritonei: a clinicopathologic and immunohistochemical study of 21 cases |journal=Mod. Pathol. |volume=28 |issue=12 |pages=1613–20 |date=December 2015 |pmid=26564007 |pmc=4682736 |doi=10.1038/modpathol.2015.116 |url=}}</ref><ref name="pmid2648802">{{cite journal |vauthors=Lovell MA, Ross GW, Cooper PH |title=Gliomatosis peritonei associated with a ventriculoperitoneal shunt |journal=Am. J. Clin. Pathol. |volume=91 |issue=4 |pages=485–7 |date=April 1989 |pmid=2648802 |doi= |url=}}</ref><ref name="pmid2412689">{{cite journal |vauthors=Nielsen SN, Scheithauer BW, Gaffey TA |title=Gliomatosis peritonei |journal=Cancer |volume=56 |issue=10 |pages=2499–503 |date=November 1985 |pmid=2412689 |doi= |url=}}</ref><ref name="pmid29977538">{{cite journal |vauthors=Ohara T, Yamanoi K, Inayama Y, Ogura J, Sakai M, Suzuki H, Hirayama T, Yasumoto K, Suginami K |title=Gliomatosis peritonei with 18F-fluorodeoxyglucose accumulation and contrast enhancement secondary to immature teratoma: A case report |journal=Mol Clin Oncol |volume=9 |issue=1 |pages=40–43 |date=July 2018 |pmid=29977538 |pmc=6031035 |doi=10.3892/mco.2018.1618 |url=}}</ref><ref name="pmid22380998">{{cite journal |vauthors=Menéndez-Sánchez P, Villarejo-Campos P, Padilla-Valverde D, Murillo-Lázaro C, Martín-Fernández J |title=Gliomatosis peritonei: recurrence, treatment and surveillance |journal=Cir Cir |volume=79 |issue=3 |pages=256–9, 278–81 |date=2011 |pmid=22380998 |doi= |url=}}</ref><ref name="WangJia2016">{{cite journal|last1=Wang|first1=Dan|last2=Jia|first2=Cong-wei|last3=Feng|first3=Rui-e|last4=Shi|first4=Hong-hui|last5=Sun|first5=Juan|title=Gliomatosis peritonei: a series of eight cases and review of the literature|journal=Journal of Ovarian Research|volume=9|issue=1|year=2016|issn=1757-2215|doi=10.1186/s13048-016-0256-5}}</ref>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Gliomatosis cerebri|Gliomatosis]] Peritonei<ref name="pmid26564007">{{cite journal |vauthors=Liang L, Zhang Y, Malpica A, Ramalingam P, Euscher ED, Fuller GN, Liu J |title=Gliomatosis peritonei: a clinicopathologic and immunohistochemical study of 21 cases |journal=Mod. Pathol. |volume=28 |issue=12 |pages=1613–20 |date=December 2015 |pmid=26564007 |pmc=4682736 |doi=10.1038/modpathol.2015.116 |url=}}</ref><ref name="pmid2648802">{{cite journal |vauthors=Lovell MA, Ross GW, Cooper PH |title=Gliomatosis peritonei associated with a ventriculoperitoneal shunt |journal=Am. J. Clin. Pathol. |volume=91 |issue=4 |pages=485–7 |date=April 1989 |pmid=2648802 |doi= |url=}}</ref><ref name="pmid2412689">{{cite journal |vauthors=Nielsen SN, Scheithauer BW, Gaffey TA |title=Gliomatosis peritonei |journal=Cancer |volume=56 |issue=10 |pages=2499–503 |date=November 1985 |pmid=2412689 |doi= |url=}}</ref><ref name="pmid29977538">{{cite journal |vauthors=Ohara T, Yamanoi K, Inayama Y, Ogura J, Sakai M, Suzuki H, Hirayama T, Yasumoto K, Suginami K |title=Gliomatosis peritonei with 18F-fluorodeoxyglucose accumulation and contrast enhancement secondary to immature teratoma: A case report |journal=Mol Clin Oncol |volume=9 |issue=1 |pages=40–43 |date=July 2018 |pmid=29977538 |pmc=6031035 |doi=10.3892/mco.2018.1618 |url=}}</ref><ref name="pmid22380998">{{cite journal |vauthors=Menéndez-Sánchez P, Villarejo-Campos P, Padilla-Valverde D, Murillo-Lázaro C, Martín-Fernández J |title=Gliomatosis peritonei: recurrence, treatment and surveillance |journal=Cir Cir |volume=79 |issue=3 |pages=256–9, 278–81 |date=2011 |pmid=22380998 |doi= |url=}}</ref><ref name="WangJia2016">{{cite journal|last1=Wang|first1=Dan|last2=Jia|first2=Cong-wei|last3=Feng|first3=Rui-e|last4=Shi|first4=Hong-hui|last5=Sun|first5=Juan|title=Gliomatosis peritonei: a series of eight cases and review of the literature|journal=Journal of Ovarian Research|volume=9|issue=1|year=2016|issn=1757-2215|doi=10.1186/s13048-016-0256-5}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Abdominal pain
* [[Abdominal pain]]


* Bloating
* Bloating
* Nausea
* [[Nausea]]
* Vomiting
* [[Vomiting]]
* Constipation
* [[Constipation]]


| style="background: #f5F5F5; text-align: center;" |–
| style="background: #f5F5F5; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Abdominal tenderness
* [[Abdominal tenderness]]


| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* SOX2+/OCT4-/NANOG- immunophenotype
* SOX2+/OCT4-/NANOG- [[immunophenotype]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Soft-tissue peritoneal nodules and masses,  
* Soft-tissue peritoneal nodules and masses,  
* Omental caking and ascites  
* Omental caking and ascites  


* Adnexal or pelvic mass  
* [[Adnexal]] or pelvic mass  
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Cystic-solid pelvic mass
* Cystic-solid [[Pelvic masses|pelvic mass]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Mature glial tissue in the peritoneal cavity  
* Mature glial tissue in the peritoneal cavity  
Line 343: Line 343:
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Associated conditions:               
* Associated conditions:               
** Solid or immature ovarian teratomas
** Solid or immature ovarian [[teratoma]]<nowiki/>s
** Ventriculoperitoneal shunts
** Ventriculoperitoneal shunts


* Immunohistochemistry:
* Immunohistochemistry:
** S100
** [[S100A1|S100]]
** CK AE1/AE3   
** CK AE1/AE3   
** Glial  fibrillary  acidic  protein  (GFAP)
** [[Glial  fibrillary  acidic  protein]] ([[GFAP]])
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Osseous|Osseous metaplasia]]<ref name="LevyShaw2009">{{cite journal|last1=Levy|first1=Angela D.|last2=Shaw|first2=Janet C.|last3=Sobin|first3=Leslie H.|title=Secondary Tumors and Tumorlike Lesions of the Peritoneal Cavity: Imaging Features with Pathologic Correlation|journal=RadioGraphics|volume=29|issue=2|year=2009|pages=347–373|issn=0271-5333|doi=10.1148/rg.292085189}}</ref><ref name="LevyShaw20092">{{cite journal|last1=Levy|first1=Angela D.|last2=Shaw|first2=Janet C.|last3=Sobin|first3=Leslie H.|title=Secondary Tumors and Tumorlike Lesions of the Peritoneal Cavity: Imaging Features with Pathologic Correlation|journal=RadioGraphics|volume=29|issue=2|year=2009|pages=347–373|issn=0271-5333|doi=10.1148/rg.292085189}}</ref>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Osseous|Osseous metaplasia]]<ref name="LevyShaw2009">{{cite journal|last1=Levy|first1=Angela D.|last2=Shaw|first2=Janet C.|last3=Sobin|first3=Leslie H.|title=Secondary Tumors and Tumorlike Lesions of the Peritoneal Cavity: Imaging Features with Pathologic Correlation|journal=RadioGraphics|volume=29|issue=2|year=2009|pages=347–373|issn=0271-5333|doi=10.1148/rg.292085189}}</ref><ref name="LevyShaw20092">{{cite journal|last1=Levy|first1=Angela D.|last2=Shaw|first2=Janet C.|last3=Sobin|first3=Leslie H.|title=Secondary Tumors and Tumorlike Lesions of the Peritoneal Cavity: Imaging Features with Pathologic Correlation|journal=RadioGraphics|volume=29|issue=2|year=2009|pages=347–373|issn=0271-5333|doi=10.1148/rg.292085189}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Abdominal pain
* [[Abdominal pain]]


* Nausea
* [[Nausea]]


* Vomiting
* [[Vomiting]]


* Bloating
* [[Bloating]]
| style="background: #f5F5F5; text-align: center;" |–
| style="background: #f5F5F5; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Abdominal tenderness
* [[Abdominal tenderness]]


* Abdominal distention
* [[Abdominal distention]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Reduced RBC
* Reduced [[RBC]]


* Positive FOBT  
* Positive [[FOBT]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* High-attenuation, linear-branching  spread along the mesentery, omentum and peritoneal surfaces.
* High-attenuation, linear-branching  spread along the mesentery, omentum and peritoneal surfaces.
Line 374: Line 374:
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Dystrophic calcification]]
* [[Dystrophic calcification]]
* Benign, mature bone with lacunae.
* Benign, mature bone with [[lacunae]].
* Focal “lace-like” osteoid
* Focal “lace-like” [[osteoid]]
* Reactive myofibroblasts with hemorrhage and fat necrosis
* Reactive [[myofibroblasts]] with hemorrhage and [[fat necrosis]]
* No tumor cell necrosis or atypical cells.  
* No tumor cell [[necrosis]] or atypical cells.  
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Biopsy and histology
* Biopsy and histology
Line 384: Line 384:


* The histologic differential diagnosis includes:
* The histologic differential diagnosis includes:
** Extraskeletal osteosarcoma
** Extraskeletal [[osteosarcoma]]
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Splenosis]]<ref name="LevyShaw2009">{{cite journal|last1=Levy|first1=Angela D.|last2=Shaw|first2=Janet C.|last3=Sobin|first3=Leslie H.|title=Secondary Tumors and Tumorlike Lesions of the Peritoneal Cavity: Imaging Features with Pathologic Correlation|journal=RadioGraphics|volume=29|issue=2|year=2009|pages=347–373|issn=0271-5333|doi=10.1148/rg.292085189}}</ref><ref name="pmid23579787">{{cite journal |vauthors=Moon C, Choi YJ, Kim EY, Lee IS, Kim SB, Jung SM, Kim SK, Chang J, Jung JY |title=Combined intrathoracic and intraperitoneal splenosis after splenic injury: case report and review of the literature |journal=Tuberc Respir Dis (Seoul) |volume=74 |issue=3 |pages=134–9 |date=March 2013 |pmid=23579787 |pmc=3617134 |doi=10.4046/trd.2013.74.3.134 |url=}}</ref><ref name="pmid14705605">{{cite journal |vauthors=Kim KA, Park CM, Kim CH, Choi SY, Park SW, Kang EY, Seol HY, Cha IH |title=An interesting hepatic mass: splenosis mimicking a hepatocellular carcinoma (2003:9b) |journal=Eur Radiol |volume=13 |issue=12 |pages=2713–5 |date=December 2003 |pmid=14705605 |doi= |url=}}</ref><ref name="pmid147056053">{{cite journal |vauthors=Kim KA, Park CM, Kim CH, Choi SY, Park SW, Kang EY, Seol HY, Cha IH |title=An interesting hepatic mass: splenosis mimicking a hepatocellular carcinoma (2003:9b) |journal=Eur Radiol |volume=13 |issue=12 |pages=2713–5 |date=December 2003 |pmid=14705605 |doi= |url=}}</ref><ref name="GaraciGrande2009">{{cite journal|last1=Garaci|first1=Francesco Giuseppe|last2=Grande|first2=Michele|last3=Villa|first3=Massimo|last4=Mancino|first4=Stefano|last5=Konda|first5=Daniel|last6=Attinà|first6=Grazia Maria|last7=Galatà|first7=Gabriele|last8=Simonetti|first8=Giovanni|title=What is a reliable CT scan for diagnosing splenosis under emergency conditions?|journal=World Journal of Gastroenterology|volume=15|issue=29|year=2009|pages=3684|issn=1007-9327|doi=10.3748/wjg.15.3684}}</ref>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Splenosis]]<ref name="LevyShaw2009">{{cite journal|last1=Levy|first1=Angela D.|last2=Shaw|first2=Janet C.|last3=Sobin|first3=Leslie H.|title=Secondary Tumors and Tumorlike Lesions of the Peritoneal Cavity: Imaging Features with Pathologic Correlation|journal=RadioGraphics|volume=29|issue=2|year=2009|pages=347–373|issn=0271-5333|doi=10.1148/rg.292085189}}</ref><ref name="pmid23579787">{{cite journal |vauthors=Moon C, Choi YJ, Kim EY, Lee IS, Kim SB, Jung SM, Kim SK, Chang J, Jung JY |title=Combined intrathoracic and intraperitoneal splenosis after splenic injury: case report and review of the literature |journal=Tuberc Respir Dis (Seoul) |volume=74 |issue=3 |pages=134–9 |date=March 2013 |pmid=23579787 |pmc=3617134 |doi=10.4046/trd.2013.74.3.134 |url=}}</ref><ref name="pmid14705605">{{cite journal |vauthors=Kim KA, Park CM, Kim CH, Choi SY, Park SW, Kang EY, Seol HY, Cha IH |title=An interesting hepatic mass: splenosis mimicking a hepatocellular carcinoma (2003:9b) |journal=Eur Radiol |volume=13 |issue=12 |pages=2713–5 |date=December 2003 |pmid=14705605 |doi= |url=}}</ref><ref name="pmid147056053">{{cite journal |vauthors=Kim KA, Park CM, Kim CH, Choi SY, Park SW, Kang EY, Seol HY, Cha IH |title=An interesting hepatic mass: splenosis mimicking a hepatocellular carcinoma (2003:9b) |journal=Eur Radiol |volume=13 |issue=12 |pages=2713–5 |date=December 2003 |pmid=14705605 |doi= |url=}}</ref><ref name="GaraciGrande2009">{{cite journal|last1=Garaci|first1=Francesco Giuseppe|last2=Grande|first2=Michele|last3=Villa|first3=Massimo|last4=Mancino|first4=Stefano|last5=Konda|first5=Daniel|last6=Attinà|first6=Grazia Maria|last7=Galatà|first7=Gabriele|last8=Simonetti|first8=Giovanni|title=What is a reliable CT scan for diagnosing splenosis under emergency conditions?|journal=World Journal of Gastroenterology|volume=15|issue=29|year=2009|pages=3684|issn=1007-9327|doi=10.3748/wjg.15.3684}}</ref>
Line 391: Line 391:
| style="background: #f5F5F5; text-align: center;" |–
| style="background: #f5F5F5; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Abdominal mass  
* [[Abdominal mass]]


* Abdominal tenderness
* [[Abdominal tenderness]]


* Abdominal rigidity and guarding due to spleen rupture in some cases and retroperitoneal bleeding.
* [[Abdominal]] rigidity and guarding due to [[spleen]] rupture in some cases and retroperitoneal bleeding.
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Absence of Howell-Jolly bodies.
* Absence of [[Howell-Jolly bodies]].
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Lobulated masses and nodules along diaphragm, and lower mediastinum of left side.  
* Lobulated masses and nodules along diaphragm, and lower [[mediastinum]] of left side.  


* Multiple calcified granulomas with fibrosis which mimic mesothelioma.
* Multiple calcified [[granulomas]] with fibrosis which mimic [[mesothelioma]].
* Homogenous splenic tissue may be seen.  
* Homogenous [[splenic]] tissue may be seen.  
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Lesions are typically multiple, small, reddish-brown nodules that range in size from a few millimeters to 7 cm
* Lesions are typically multiple, small, reddish-brown [[nodules]] that range in size from a few millimeters to 7 cm
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Biopsy and Histopathology  
* Biopsy and Histopathology  
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Pathogenesis:  
* [[Pathogenesis]]:  
** Mechanical implantation of splenic tissue after splenectomy or splenic rupture.
** Mechanical implantation of splenic tissue after [[splenectomy]] or splenic rupture.
* Non-invasive diagnostic method of choice:
* Non-invasive diagnostic method of choice:
** Tc-99m-labeled heat-damaged RBC scan
** Tc-99m-labeled heat-damaged [[RBC]] scan
* Liver splenosis can mimic hepatocellular carcinoma.
* Liver splenosis can mimic [[hepatocellular carcinoma]].
* Most common extraperitoneal site of splenosis is thoracic.
* Most common extraperitoneal site of [[splenosis]] is [[thoracic]].
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Melanosis]]<ref name="pmid26619112">{{cite journal |vauthors=Chang ES, Bachul P, Szura M, Szpor J, Okoń K, Walocha JA |title=Peritoneal "melanosis" |journal=Pol J Pathol |volume=66 |issue=3 |pages=330–3 |date=September 2015 |pmid=26619112 |doi= |url=}}</ref><ref name="pmid20346227">{{cite journal |vauthors=Gao R, Liu NF, Sheng XG |title=Malignant ovarian melanoma with extensive pelvic and peritoneal metastasis: a case report and literature review |journal=Chin J Cancer |volume=29 |issue=4 |pages=460–2 |date=April 2010 |pmid=20346227 |doi= |url=}}</ref><ref name="pmid20173496">{{cite journal |vauthors=Kim SS, Nam JH, Kim SM, Choi YD, Lee JH |title=Peritoneal melanosis associated with mucinous cystadenoma of the ovary and adenocarcinoma of the colon |journal=Int. J. Gynecol. Pathol. |volume=29 |issue=2 |pages=113–6 |date=March 2010 |pmid=20173496 |doi=10.1097/PGP.0b013e3181bb4182 |url=}}</ref><ref name="pmid9434025">{{cite journal |vauthors=De la Torre Mondragón L, Daza DC, Bustamante AP, Fascinetto GV |title=Gastric triplication and peritoneal melanosis |journal=J. Pediatr. Surg. |volume=32 |issue=12 |pages=1773–5 |date=December 1997 |pmid=9434025 |doi= |url=}}</ref><ref>{{cite journal|doi=10.5114/pjp.2015.549}}</ref>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Melanosis]]<ref name="pmid26619112">{{cite journal |vauthors=Chang ES, Bachul P, Szura M, Szpor J, Okoń K, Walocha JA |title=Peritoneal "melanosis" |journal=Pol J Pathol |volume=66 |issue=3 |pages=330–3 |date=September 2015 |pmid=26619112 |doi= |url=}}</ref><ref name="pmid20346227">{{cite journal |vauthors=Gao R, Liu NF, Sheng XG |title=Malignant ovarian melanoma with extensive pelvic and peritoneal metastasis: a case report and literature review |journal=Chin J Cancer |volume=29 |issue=4 |pages=460–2 |date=April 2010 |pmid=20346227 |doi= |url=}}</ref><ref name="pmid20173496">{{cite journal |vauthors=Kim SS, Nam JH, Kim SM, Choi YD, Lee JH |title=Peritoneal melanosis associated with mucinous cystadenoma of the ovary and adenocarcinoma of the colon |journal=Int. J. Gynecol. Pathol. |volume=29 |issue=2 |pages=113–6 |date=March 2010 |pmid=20173496 |doi=10.1097/PGP.0b013e3181bb4182 |url=}}</ref><ref name="pmid9434025">{{cite journal |vauthors=De la Torre Mondragón L, Daza DC, Bustamante AP, Fascinetto GV |title=Gastric triplication and peritoneal melanosis |journal=J. Pediatr. Surg. |volume=32 |issue=12 |pages=1773–5 |date=December 1997 |pmid=9434025 |doi= |url=}}</ref><ref>{{cite journal|doi=10.5114/pjp.2015.549}}</ref>
Line 423: Line 423:
| style="background: #f5F5F5; text-align: center;" |–
| style="background: #f5F5F5; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Abdominal distention in case of peritonitis,otherwise no findings.
* Abdominal distention in case of [[peritonitis]],otherwise no findings.
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Majority have normal lab values
* Majority have normal lab values


* Positive FOBT reported in a case with colorectal polyp
* Positive [[FOBT]] reported in a case with [[colorectal polyp]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Pigmentation within the dermoid, [[omentum]], and peritoneal cavity  
* Pigmentation within the [[dermoid]], [[omentum]], and peritoneal cavity  


* Pigment-laden [[macrophage]]<nowiki/>s within the mucosa on PAS staining
* Pigment-laden [[macrophage]]<nowiki/>s within the mucosa on PAS staining
Line 438: Line 438:
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Associated diseases:
* Associated diseases:
** Enteric duplication cyst
** [[Enteric duplication cysts|Enteric duplication cyst]]
** Ovarian cystic teratomas
** [[Ovarian cysts|Ovarian cystic teratomas]]
** Gastric triplication  
** Gastric triplication  
*Immunohistochemistry:
*Immunohistochemistry:
** Positive for CD68  
** Positive for [[CD68]]
** Negative melanin-A
** Negative [[Melanin|melanin-A]]
** Negative HMB-45
** Negative [[HMB-45]]
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Inflammatory Pseudotumor]]<ref name="MavesJohnson1989">{{cite journal|last1=Maves|first1=C K|last2=Johnson|first2=J F|last3=Bove|first3=K|last4=Malott|first4=R L|title=Gastric inflammatory pseudotumor in children.|journal=Radiology|volume=173|issue=2|year=1989|pages=381–383|issn=0033-8419|doi=10.1148/radiology.173.2.2678252}}</ref>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Inflammatory Pseudotumor]]<ref name="MavesJohnson1989">{{cite journal|last1=Maves|first1=C K|last2=Johnson|first2=J F|last3=Bove|first3=K|last4=Malott|first4=R L|title=Gastric inflammatory pseudotumor in children.|journal=Radiology|volume=173|issue=2|year=1989|pages=381–383|issn=0033-8419|doi=10.1148/radiology.173.2.2678252}}</ref>
Line 450: Line 450:
* [[Fever]]
* [[Fever]]


* Weight loss  
* [[Weight loss]]


* Growth retardation
* [[Growth retardation]]
* Fatigue  
* [[Fatigue (physical)|Fatigue]]
* Symptoms related to mass effect,
* Symptoms related to mass effect
| style="background: #f5F5F5; text-align: center;" |–
| style="background: #f5F5F5; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
Line 466: Line 466:


* Polyclonal [[hypergammaglobulinemia]]
* Polyclonal [[hypergammaglobulinemia]]
* Stain positive for [[ALK(+)-ALCL|ALK]] with immunohistochemistry
* Stain positive for [[ALK(+)-ALCL|ALK]] with [[immunohistochemistry]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* CT findings are non specific [[ascites]], masses may be seen in [[peritoneum]],mimic neoplasm.
* CT findings are non specific [[ascites]], masses may be seen in [[peritoneum]],mimic neoplasm.
Line 473: Line 473:
* Loose myxoid areas with interspersed [[spindle cells]],  
* Loose myxoid areas with interspersed [[spindle cells]],  


* Variable vascularity  
* Variable [[vascularity]]
* Dense [[collagen]], and dense spindled [[myofibroblasts]] mixed with inflammatory cells, include [[plasma cells]] and [[lymphocytes]].
* Dense [[collagen]], and dense spindled [[myofibroblasts]] mixed with inflammatory cells, include [[plasma cells]] and [[lymphocytes]].
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Biopsy and histology
* [[Biopsy]] and histology
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Chromosomal translocations:
* [[Chromosomal translocation]]<nowiki/>s:
** [[ALK(+)-ALCL|ALK]] gene
** [[ALK(+)-ALCL|ALK]] gene
* Immunochemistry:
* Immunochemistry:

Revision as of 20:51, 23 January 2019

Pseudomyxoma peritonei Microchapters

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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] Parminder Dhingra, M.D. [3]

Overview

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

Differential Diagnosis

Pseudomyxoma peritonei must be differentiated from:[1][2]

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[3][4][5][6] –
  • Non specific
  • Low-attenuation
  • Scalloping of the visceral surfaces differentiates pseudomyxoma from other causes of peritnoitis.
  • Typically does not invade visceral organs or spread by lymphatic or hematogenous routes unlike mucinous carcinomatosis
  • 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)
  • Gelatinous ascites in peritoneum and visceral organs,usually underneath the right hemidiaphragm, liver.
  • Omental cake
  • Diagnostic laparascopy/laparatomy
  • Immunohistochemisty
Peritoneal carcinomatosis without mucinous ascites[7][8][9] –
  • Echoes are mobile
  • Depending on primary tumor origin ( colorectal,ovary, appendix)
  • Laparascopy/laparatomy tissue sampling
Peritoneal sarcomatosis[10][11] –
  • Heterogeneous bulky masses
  • Hypervascularity with or without hemoperitoneum
  • Variable presence of ascites.
  • Hyperechogenic mass
  • Little ascites
  • Soft-tissue implants along the peritoneum
  • CT-guided percutaneous tissue biopsy
Lymphomatosis[12][13][14][10] +
  • Aneurysmal dilatation of the bowel loop with wall thickening.
  • Enlarged supraclavicular, mediastinal and para-aortic lymph nodes.
Tuberculosis Peritonitis[15][16] +
  • Miliary microabscesses in the liver or spleen
  • Ascites/loculated fluid
  • Peritoneal thickening
  • Omental thickening
  • Immunohistochemistry
Endometriosis[17][18][19][20][21]
  • Menstrual cramps
  • Painful bowel movements
  • Painful urination during menstrual periods
  • Heavy menstrual periods
  • Pain during or after sex
 –
  • Fixed and retroverted uterus
  • Thomsen-Friedenreich (T) antigen (Gal beta1-3GalNAc)
  • Hypoechogenic linear thickening or nodules/masses
  • Hemorrhagic, reddish brown nodules on the surfaces of peritoneum.
Sclerosing encapsulating peritonitis[22][23][24][25]
  • Weight loss
 –
  • Increased CRP level
  • Fibrin-fibrin degradation product
  • Thin echogenic strands can be seen within ascitic fluid
  • Tethered small bowel
  • Dense,opaque peritoneum
  • Histology
Gliomatosis Peritonei[26][27][28][29][30][31] –
  • Soft-tissue peritoneal nodules and masses,
  • Omental caking and ascites
  • Mature glial tissue in the peritoneal cavity
  • Micronodular growth pattern
  • Multiple small peritoneal implants
  • Diagnostic laparascopy and biopsy.
  • Associated conditions:
    • Solid or immature ovarian teratomas
    • Ventriculoperitoneal shunts
Osseous metaplasia[10][32] –
  • High-attenuation, linear-branching spread along the mesentery, omentum and peritoneal surfaces.
  • Biopsy and histology
  • Occurs after trauma or surgery
  • The histologic differential diagnosis includes:
Splenosis[10][33][34][35][36]
  • Increase in abdominal girth
 –
  • Abdominal rigidity and guarding due to spleen rupture in some cases and retroperitoneal bleeding.
  • Lobulated masses and nodules along diaphragm, and lower mediastinum of left side.
  • Lesions are typically multiple, small, reddish-brown nodules that range in size from a few millimeters to 7 cm
  • Biopsy and Histopathology
Melanosis[37][38][39][40][41]
  • Majority of cases are asymptomatic
  • Increase in abdominal girth
 –
  • Abdominal distention in case of peritonitis,otherwise no findings.
  • Majority have normal lab values
  • Pigment-laden macrophages within the mucosa on PAS staining
Inflammatory Pseudotumor[42] –
  • CT findings are non specific ascites, masses may be seen in peritoneum,mimic neoplasm.

References

  1. ↑ Harmon RL, Sugarbaker PH (February 2005). "Prognostic indicators in peritoneal carcinomatosis from gastrointestinal cancer". Int Semin Surg Oncol. 2 (1): 3. doi:10.1186/1477-7800-2-3. PMC 549516. PMID 15701175.
  2. ↑ Carr NJ, Bibeau F, Bradley RF, Dartigues P, Feakins RM, Geisinger KR, Gui X, Isaac S, Milione M, Misdraji J, Pai RK, Rodriguez-Justo M, Sobin LH, van Velthuysen MF, Yantiss RK (December 2017). "The histopathological classification, diagnosis and differential diagnosis of mucinous appendiceal neoplasms, appendiceal adenocarcinomas and pseudomyxoma peritonei". Histopathology. 71 (6): 847–858. doi:10.1111/his.13324. PMID 28746986.
  3. ↑ Carranza-Martínez I, Cornejo-López G, Monroy-Argumedo M, Villanueva-Sáenz E (2014). "[Pseudomyxoma peritonei. Two-case-report]". Cir Cir (in Spanish; Castilian). 82 (2): 206–11. PMID 25312322.
  4. ↑ Ronnett BM, Zahn CM, Kurman RJ, Kass ME, Sugarbaker PH, Shmookler BM (December 1995). "Disseminated peritoneal adenomucinosis and peritoneal mucinous carcinomatosis. A clinicopathologic analysis of 109 cases with emphasis on distinguishing pathologic features, site of origin, prognosis, and relationship to "pseudomyxoma peritonei"". Am. J. Surg. Pathol. 19 (12): 1390–408. PMID 7503361.
  5. ↑ Carr, Norman J.; Cecil, Thomas D.; Mohamed, Faheez; Sobin, Leslie H.; Sugarbaker, Paul H.; González-Moreno, Santiago; Taflampas, Panos; Chapman, Sara; Moran, Brendan J. (2016). "A Consensus for Classification and Pathologic Reporting of Pseudomyxoma Peritonei and Associated Appendiceal Neoplasia". The American Journal of Surgical Pathology. 40 (1): 14–26. doi:10.1097/PAS.0000000000000535. ISSN 0147-5185.
  6. ↑ O'Connell JT, Tomlinson JS, Roberts AA, McGonigle KF, Barsky SH (August 2002). "Pseudomyxoma peritonei is a disease of MUC2-expressing goblet cells". Am. J. Pathol. 161 (2): 551–64. doi:10.1016/S0002-9440(10)64211-3. PMC 1850719. PMID 12163380.
  7. ↑ Winder T, Lenz HJ (2010). "Mucinous adenocarcinomas with intra-abdominal dissemination: a review of current therapy". Oncologist. 15 (8): 836–44. doi:10.1634/theoncologist.2010-0052. PMC 3228029. PMID 20656916.
  8. ↑ Kusamura S, Baratti D, Zaffaroni N, Villa R, Laterza B, Balestra MR, Deraco M (January 2010). "Pathophysiology and biology of peritoneal carcinomatosis". World J Gastrointest Oncol. 2 (1): 12–8. doi:10.4251/wjgo.v2.i1.12. PMC 2999153. PMID 21160812.
  9. ↑ Coccolini F, Gheza F, Lotti M, Virzì S, Iusco D, Ghermandi C, Melotti R, Baiocchi G, Giulini SM, Ansaloni L, Catena F (November 2013). "Peritoneal carcinomatosis". World J. Gastroenterol. 19 (41): 6979–94. doi:10.3748/wjg.v19.i41.6979. PMC 3819534. PMID 24222942.
  10. ↑ 10.0 10.1 10.2 10.3 Levy, Angela D.; Shaw, Janet C.; Sobin, Leslie H. (2009). "Secondary Tumors and Tumorlike Lesions of the Peritoneal Cavity: Imaging Features with Pathologic Correlation". RadioGraphics. 29 (2): 347–373. doi:10.1148/rg.292085189. ISSN 0271-5333.
  11. ↑ Oei TN, Jagannathan JP, Ramaiya N, Ros PR (September 2010). "Peritoneal sarcomatosis versus peritoneal carcinomatosis: imaging findings at MDCT". AJR Am J Roentgenol. 195 (3): W229–35. doi:10.2214/AJR.09.3907. PMID 20729420.
  12. ↑ Weng SC, Wu CY (December 2008). "Lymphoma presenting as peritoneal lymphomatosis with ascites". J Chin Med Assoc. 71 (12): 646–50. doi:10.1016/S1726-4901(09)70009-7. PMID 19114331.
  13. ↑ Horger M, Müller-Schimpfle M, Yirkin I, Wehrmann M, Claussen CD (January 2004). "Extensive peritoneal and omental lymphomatosis with raised CA 125 mimicking carcinomatosis: CT and intraoperative findings". Br J Radiol. 77 (913): 71–3. doi:10.1259/bjr/35139284. PMID 14988144.
  14. ↑ Cunningham N, Ffrench-Constant S, Planche K, Gillmore R (February 2015). "Peritoneal lymphomatosis: a rare presentation of follicular lymphoma mimicking peritoneal carcinomatosis". BMJ Case Rep. 2015. doi:10.1136/bcr-2014-207136. PMC 4336898. PMID 25694630.
  15. ↑ Kaya M, Kaplan MA, Isikdogan A, Celik Y (2011). "Differentiation of tuberculous peritonitis from peritonitis carcinomatosa without surgical intervention". Saudi J Gastroenterol. 17 (5): 312–7. doi:10.4103/1319-3767.84484. PMC 3178918. PMID 21912057.
  16. ↑ Yapar, E. G.; Ekici, E.; Karasahin, E.; Gökmen, O. (1995). "Sonographic features of tuberculous peritonitis with female genital tract tuberculosis". Ultrasound in Obstetrics and Gynecology. 6 (2): 121–125. doi:10.1046/j.1469-0705.1995.06020121.x. ISSN 0960-7692.
  17. ↑ DiVasta AD, Vitonis AF, Laufer MR, Missmer SA (March 2018). "Spectrum of symptoms in women diagnosed with endometriosis during adolescence vs adulthood". Am. J. Obstet. Gynecol. 218 (3): 324.e1–324.e11. doi:10.1016/j.ajog.2017.12.007. PMID 29247637.
  18. ↑ Yeaman GR, Collins JE, Lang GA (March 2002). "Autoantibody responses to carbohydrate epitopes in endometriosis". Ann. N. Y. Acad. Sci. 955: 174–82, discussion 199–200, 396–406. PMID 11949946.
  19. ↑ Kennedy S, Bergqvist A, Chapron C, D'Hooghe T, Dunselman G, Greb R, Hummelshoj L, Prentice A, Saridogan E (October 2005). "ESHRE guideline for the diagnosis and treatment of endometriosis". Hum. Reprod. 20 (10): 2698–704. doi:10.1093/humrep/dei135. PMID 15980014.
  20. ↑ Hsu AL, Khachikyan I, Stratton P (June 2010). "Invasive and noninvasive methods for the diagnosis of endometriosis". Clin Obstet Gynecol. 53 (2): 413–9. doi:10.1097/GRF.0b013e3181db7ce8. PMC 2880548. PMID 20436318.
  21. ↑ Bloski, Terri; Pierson, Roger (2008). "Endometriosis and Chronic Pelvic Pain: Unraveling the Mystery Behind this Complex Condition". Nursing for Women's Health. 12 (5): 382–395. doi:10.1111/j.1751-486X.2008.00362.x. ISSN 1751-4851.
  22. ↑ Suh WN, Lee SK, Chang H, Hwang HJ, Hyung WJ, Park YN, Kim TI (June 2007). "Sclerosing encapsulating peritonitis (abdominal cocoon) after abdominal hysterectomy". Korean J. Intern. Med. 22 (2): 125–9. PMC 2687622. PMID 17616031.
  23. ↑ Al Ani AH, Al Zayani N, Najmeddine M, Jacob S, Nair S (2014). "Idiopathic sclerosing encapsulating peritonitis (abdominal cocoon) in adult male. A case report". Int J Surg Case Rep. 5 (10): 735–8. doi:10.1016/j.ijscr.2014.07.017. PMC 4189066. PMID 25217877.
  24. ↑ Sharma D, Nair RP, Dani T, Shetty P (2013). "Abdominal cocoon-A rare cause of intestinal obstruction". Int J Surg Case Rep. 4 (11): 955–7. doi:10.1016/j.ijscr.2013.08.004. PMC 3825929. PMID 24055916.
  25. ↑ Machado NO (May 2016). "Sclerosing Encapsulating Peritonitis: Review". Sultan Qaboos Univ Med J. 16 (2): e142–51. doi:10.18295/squmj.2016.16.02.003. PMC 4868512. PMID 27226904.
  26. ↑ Liang L, Zhang Y, Malpica A, Ramalingam P, Euscher ED, Fuller GN, Liu J (December 2015). "Gliomatosis peritonei: a clinicopathologic and immunohistochemical study of 21 cases". Mod. Pathol. 28 (12): 1613–20. doi:10.1038/modpathol.2015.116. PMC 4682736. PMID 26564007.
  27. ↑ Lovell MA, Ross GW, Cooper PH (April 1989). "Gliomatosis peritonei associated with a ventriculoperitoneal shunt". Am. J. Clin. Pathol. 91 (4): 485–7. PMID 2648802.
  28. ↑ Nielsen SN, Scheithauer BW, Gaffey TA (November 1985). "Gliomatosis peritonei". Cancer. 56 (10): 2499–503. PMID 2412689.
  29. ↑ Ohara T, Yamanoi K, Inayama Y, Ogura J, Sakai M, Suzuki H, Hirayama T, Yasumoto K, Suginami K (July 2018). "Gliomatosis peritonei with 18F-fluorodeoxyglucose accumulation and contrast enhancement secondary to immature teratoma: A case report". Mol Clin Oncol. 9 (1): 40–43. doi:10.3892/mco.2018.1618. PMC 6031035. PMID 29977538.
  30. ↑ Menéndez-Sánchez P, Villarejo-Campos P, Padilla-Valverde D, Murillo-Lázaro C, Martín-Fernández J (2011). "Gliomatosis peritonei: recurrence, treatment and surveillance". Cir Cir. 79 (3): 256–9, 278–81. PMID 22380998.
  31. ↑ Wang, Dan; Jia, Cong-wei; Feng, Rui-e; Shi, Hong-hui; Sun, Juan (2016). "Gliomatosis peritonei: a series of eight cases and review of the literature". Journal of Ovarian Research. 9 (1). doi:10.1186/s13048-016-0256-5. ISSN 1757-2215.
  32. ↑ Levy, Angela D.; Shaw, Janet C.; Sobin, Leslie H. (2009). "Secondary Tumors and Tumorlike Lesions of the Peritoneal Cavity: Imaging Features with Pathologic Correlation". RadioGraphics. 29 (2): 347–373. doi:10.1148/rg.292085189. ISSN 0271-5333.
  33. ↑ Moon C, Choi YJ, Kim EY, Lee IS, Kim SB, Jung SM, Kim SK, Chang J, Jung JY (March 2013). "Combined intrathoracic and intraperitoneal splenosis after splenic injury: case report and review of the literature". Tuberc Respir Dis (Seoul). 74 (3): 134–9. doi:10.4046/trd.2013.74.3.134. PMC 3617134. PMID 23579787.
  34. ↑ Kim KA, Park CM, Kim CH, Choi SY, Park SW, Kang EY, Seol HY, Cha IH (December 2003). "An interesting hepatic mass: splenosis mimicking a hepatocellular carcinoma (2003:9b)". Eur Radiol. 13 (12): 2713–5. PMID 14705605.
  35. ↑ Kim KA, Park CM, Kim CH, Choi SY, Park SW, Kang EY, Seol HY, Cha IH (December 2003). "An interesting hepatic mass: splenosis mimicking a hepatocellular carcinoma (2003:9b)". Eur Radiol. 13 (12): 2713–5. PMID 14705605.
  36. ↑ Garaci, Francesco Giuseppe; Grande, Michele; Villa, Massimo; Mancino, Stefano; Konda, Daniel; Attinà, Grazia Maria; Galatà, Gabriele; Simonetti, Giovanni (2009). "What is a reliable CT scan for diagnosing splenosis under emergency conditions?". World Journal of Gastroenterology. 15 (29): 3684. doi:10.3748/wjg.15.3684. ISSN 1007-9327.
  37. ↑ Chang ES, Bachul P, Szura M, Szpor J, Okoń K, Walocha JA (September 2015). "Peritoneal "melanosis"". Pol J Pathol. 66 (3): 330–3. PMID 26619112.
  38. ↑ Gao R, Liu NF, Sheng XG (April 2010). "Malignant ovarian melanoma with extensive pelvic and peritoneal metastasis: a case report and literature review". Chin J Cancer. 29 (4): 460–2. PMID 20346227.
  39. ↑ Kim SS, Nam JH, Kim SM, Choi YD, Lee JH (March 2010). "Peritoneal melanosis associated with mucinous cystadenoma of the ovary and adenocarcinoma of the colon". Int. J. Gynecol. Pathol. 29 (2): 113–6. doi:10.1097/PGP.0b013e3181bb4182. PMID 20173496.
  40. ↑ De la Torre Mondragón L, Daza DC, Bustamante AP, Fascinetto GV (December 1997). "Gastric triplication and peritoneal melanosis". J. Pediatr. Surg. 32 (12): 1773–5. PMID 9434025.
  41. ↑ . doi:10.5114/pjp.2015.549. Missing or empty |title= (help)
  42. ↑ Maves, C K; Johnson, J F; Bove, K; Malott, R L (1989). "Gastric inflammatory pseudotumor in children". Radiology. 173 (2): 381–383. doi:10.1148/radiology.173.2.2678252. ISSN 0033-8419.

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