Abstract
The patient was a 29-year-old male who visited our hospital complaining of pain from the abdomen to the back through the left side. Chest-abdominal CT showed a large number of nodules and enlarged lymph nodes with right pleural effusion and ascites. PET-CT showed FDG uptake of advanced pleural and peritoneal ascites. Levels of serum CEA, CA125 and sIL-2R were increased. From the above results, it was necessary to distinguish among peritonitis carcinomatosa, malignant lymphoma and malignant mesothelioma of tuberculous peritonitis. Since it was difficult to establish a definitive diagnosis, laparoscopic biopsy of the peritoneum was performed. A large number of white nodules were diffused in the peritoneum, the surface of the liver and the greater omentum. The parietal side of the peritoneum closely adhered to the greater omentum. On the basis of rapid perioperative histopathological diagnosis, the patient was diagnosed as having tuberculous peritonitis. Tuberculous peritonitis is rare. Thus, the diagnosis is difficult based on clinical findings and examinations. An exploratory laparoscopy and rapid perioperative histopathological examination would be effective for accurate diagnosis.
