MULTIORGAN ULTRASOUND FINDINGS IN A CHILD WITH NONHODGKIN'S LYMPHOMA

CASE DETAILS-  A 6 yrs old boy presented with wt loss, pain abdomen, occasional vomiting & painless scrotal swelling. 

USG ABDOMEN- showed -

(1) Mild  hepatomegaly with multiple rounded hypoechoic solid nodular masses ranging 15 to 45 mm size involving both lobes. 

(2) A 6 cms long segment Jejunal loop hypoechoic concentric mural thickening ( 10 mm) in left upper abdomen with mild luminal dilatation ( classical aneurysmal dilatation with target sign ) . Rest bowel was normal.

(3) A large 4 cms sized rounded adjacent mesenteric nodal mass

(4) Slight omental thickening

(5) Mild ascites

Fig 1- Hepatic US scan shows multiple rounded hypoechoic nodular metastatic masses

Fig 2-  Left upper abdominal US scan shows hypoechoic concentric Jejunal loop thickening with aneurysmal dilatation. Adjacent rounded hypoechoic mesenteric nodal mass also seen.

SCROTAL USG - findings were -

(1) Mildly bulky homogeneously hypoechoic both testes with mild hyperemia on doppler 

(2) Diffusely hypoechoic epididymis 

(3) Markedly thick inhomogenic hypoechoic & hyperemic extratesticular mass due to cord thickening, which is extending upto inguinal canal regions

(4) No hydrocele was present

Fig 3 - Scrotal US & color doppler scan showing homogeneously hypoechoic & hyperemic testis , & extratesticular masses due to cord & epididymal swelling.

Fig 4 - scrotal US scan showing hypoechoic testis & extratesticular masses due to cord and epididymal infiltration 

Fig 5- Quad US & color doppler images of both sided  supratesticular spermatic cords showing hypoechoic & hyperemic thickening of entire cord extending upto inguinal canal.

PS -1) The case study is intended for medical professionals and imaging specialists for academic purposes 

2) FNAC from hepatic nodule & testis showed NONHODGKIN'S LYMPHOMA