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Case Report
 
A misdiagnosis of benign abdominal mass as a non-Hodgkin lymphoma
Luma Haj Kassem1, Ahmad Ghazal2, Khawla Mayoh1, Najat Mehio Sailam1
1MD, University of Aleppo Faculty of Medicine, Aleppo, Syria
2MD, PhD, Gs, Surgery Department, Aleppo University Hospital, Aleppo, Syria

Article ID: Z01201706CR10795LK
doi:10.5348/ijcri-201756-CR-10795

Address correspondence to:
Luma Haj Kassem
PO Box 1089
Aleppo
Syria

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How to cite this article
Kassem LH, Ghazal A, Mayoh K, Sailam NM. A misdiagnosis of benign abdominal mass as a non-Hodgkin lymphoma. Int J Case Rep Images 2017;8(6):397–401.

ABSTRACT

Introduction: Vascular transformation of sinuses (VTS) is a rare reactive process. The lymph node sinuses got converted into a complex anastomosing network of vascular channels.
Case Report: We report a unique case of VTS in a healthy 13-year-old female who complained only of abdominal pain with no other findings. She was misdiagnosed as non-Hodgkin lymphoma by FNA on a retrocaval mass and administered with chemotherapy before performing an excisional biopsy. Her pain recurred after a year; another course of chemotherapy was determined, but the patient and her parents refused it. Another clinician was consulted and he decided to perform an excisional biopsy which revealed VTS with no malignancy.
Conclusion: By reviewing literature, the majority of VTS cases were reported in adults and associated with neoplasia, but the case described here may be the first case to be reported about VTS in a child, who has been healthy to date. We also report this case to emphasize the role of diagnosis before making any therapeutic procedure, in particular chemotherapy.

Keywords: Lymph node, Lymphoma, Misdiagnosis, Vascular transformation



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Acknowledgements
We are thankful to Dr. Mohamed Imad Eddin Mouhandes (MD), Consulting Pathologist, Dr. Rama Faour (MD), University of Aleppo faculty of Medicine, Ms. Manal Mehio Sailam and Ms. Nour Ajam, University of Aleppo, faculty of Arts and Humanities, Aleppo, Syria, for their contribution.

Author Contributions
Luma Haj Kassem – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Ahmad Ghazal – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Khawla Mayoh – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Najat Mehio Sailam – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2017 Luma Haj Kassem et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.