Imaging in Oncology
IMAGING OF ABDOMINAL PAIN
Evan W. Harris, MD, Assistant Professor and Scott Fargher, MS,
Radiology Service, H. Lee Moffitt Cancer Center & Research Institute
This regular feature will enhance your knowledge of imaging technology in oncologic
diagnosis, treatment, and evaluation.
Case Description:
A 50-year-old woman with a history of non-Hodgkin's lymphoma, diffuse large cell,
mantle cell lymphoma (according to the revised European-American classification of
lymphoid neoplasms), which was treated previously with cyclophosphamide, doxorubicin,
vincristine, and prednisone (CHOP) and VP-16 (etoposide) and more recently with
fludarabine, mitoxantrone, and dexamethasone (FMD), presents with abdominal pain for 24
hours. Enhanced computed tomography (CT) of the abdomen (Figs 1A-B) reveals mesenteric and
more heterogeneous posterior right lower quadrant masses, in addition to bowel dilatation
with air fluid levels.
Which of the following choices is the most appropriate diagnosis?
- cecal volvulus with small bowel obstruction
- ischemic bowel secondary to compression of mesenteric vessels by lymphomatous mass
- mesenteric adenopathy causing extrinsic bowel compression and small bowel obstruction
- intussusception with small bowel obstruction secondary to lymphomatous bowel
involvement, and mesenteric adenopathy
- typhlitis with small bowel obstruction
Turn to the next page for answer and discussion
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Volume 4 Number 1