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Insights into Imaging
Fig. 29 | Insights into Imaging

Fig. 29

From: Primary and secondary tumors of the peritoneum: key imaging features and differential diagnosis with surgical and pathological correlation

Fig. 29

Tuberculous peritonitis in a 42-year-old male from Ecuador, presenting with constitutional syndrome, evening fever and abdominal pain. Axial (a, b) and coronal c, d CT images in the portal phase show diffuse thickening of the peritoneal folds (red arrows), stranding of the omental fat (white arrows) and ascites (white asterisks), mimicking peritoneal carcinomatosis or primary tumor of the peritoneum. Laparoscopic peritoneal biopsy was made and H&E stain photomicrograph (e) showed multiple granulomas with multinucleated giant cells (circles), suggesting peritoneal tuberculosis. Ascitic fluid PCR for mycobacterium tuberculosis was positive, confirming the clinical suspicion. f Follow-up CT scan made 6 months after tuberculostatic treatment shows a complete response, with resolution of the thickening of the peritoneal folds, the stranding of the omental fat and the ascites

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