title: Tuberculous peritonitis with infracarinal mass and elevated CA-125 in a 13-year-old girl.
abstract: A 13-year-old girl with weight loss and ascites was admitted with suspicion of a malignant disease. Abdominal magnetic resonance imaging indicated extensive peritonitis and showed no evidence of a solid tumor. As a new imaging observation, thoracic computed tomography showed a lymphoma-like infracarinal mass and further enlarged lymph nodes in the pathway of draining lymph ducts. A tuberculin skin test and an interferon-gamma blood test were positive, and the tumor marker CA-125 was elevated. Histology of a peritoneal biopsy showed infectious granulomas with central necrosis, and Mycobacterium tuberculosis could be cultured, leading to the diagnosis of a tuberculous peritonitis. The girl received multi-drug anti-tuberculous treatment and subsequently recovered. At follow-up the peritonitis and the infracarinal mass had vanished. In conclusion, tuberculous peritonitis is a rare but relevant differential diagnosis in peritonitis of unknown origin. Its diagnosis is facilitated by imaging, by tuberculosis skin and blood tests, and by clinical interpretation.
authors: Department of Diagnostic Radiology, University Hospital, Robert-Koch-Strasse 40, 37075, Goettingen, Germany, Menke-J@T-Online.de.
authors: Jan
authors: J
authors: Menke
authors: Ingrid
authors: I
authors: Kühnle
mesh_terms: D000293:Adolescent; D000995:Antitubercular Agents / Q000627:therapeutic use*; D018394:CA-125 Antigen / Q000097:blood*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000097:blood; D008198:Lymph Nodes / Q000382:microbiology* / Q000473:pathology; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D014395:Peritonitis, Tuberculous / Q000188:drug therapy* / Q000382:microbiology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014374:Tuberculin Test
chemical_list: D000995:Antitubercular Agents; D018394:CA-125 Antigen; D007371:Interferon-gamma
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