Ces radiol. 2018, 72(2):96-99 | DOI: 10.55095/CesRadiol2018/016

Periaortic lymphoma mimicking infectious complication after EVARCase report

Milan Vajda¹, Jan Raupach¹, Antonín Krajina¹, Miroslav Lojík¹, Petr Hoffmann¹, Michal Hůlek¹, Ondřej Živný¹, Radovan Malý², Veronika Vršanská², David Belada³

¹ Radiologická klinika LF UK a FN, Hradec Králové

² I. interní kardioangiologická klinika LF UK a FN, Hradec Králové

³ IV. interní hematologická klinika LF UK a FN, Hradec Králové

Our case report presents an 85-year-old patient with an abdominal aortic aneurysm (AAA) who underwent endovascular treatment in 2012 by implanting bifurcated stent graft, and after 5 years of its stability, the aneurysm sac suddenly dilated. The suspected distal endoleak (type Ib) was considered to be the cause, so we decided to extend the original stent graft. The following posttreatment CT scan revealed a large periaortic infiltration, that was considered as infectious complication of the stent graft implantation. To investigate the origin of the retroperitoneal infiltration, we performed percutaneous biopsy through transcaval approach. The final diagnose was an aggressive high-grade diffuse large-cell B-cell lymphoma, that probably invaded the aorta wall and cause expansion of the originally stable AAA with stent graft. Its early diagnosis allowed prompt oncology treatment. Differential diagnosis of retroperitoneal infiltration includes bacterial infection, idiopathic retroperitoneal fibrosis and, in rare cases as presented here, lymphoma.

Keywords: abdominal aortic aneurysm, EVAR, lymphoma

Accepted: April 4, 2018; Published: June 1, 2018  Show citation