GIT lymphoma of distal bowel misDx as intra-abdominal absces
Primary gastrointestinal lymphoma, though rare, is the most common gastrointestinal malignancy in children. Signs and symptoms are nonspecific and include abdominal pain, nausea, emesis, and a palpable abdominal mass.

Imaging is therefore typically required to differentiate gastrointestinal lymphoma from other abdominal conditions. Published in the journal Radiology Case Reports, the authors present a pediatric case of primary gastrointestinal lymphoma involving the distal bowel that was initially misdiagnosed as an intra-abdominal abscess.

This case, published in Radiology Case Reports, highlights the imaging findings of primary gastrointestinal lymphoma, potential pitfalls in imaging diagnosis, and the role of accurate imaging diagnosis in expediting patient management to reduce associated morbidity and mortality.

An 11-year-old previously healthy boy presented with a 1-month history of abdominal pain that acutely worsened in the 3 days immediately prior to presentation. He also complained of a 1-month history of nausea, anorexia, and a 10-pound weight loss.

On physical examination, the child was afebrile, with a diffusely tender abdomen, and a positive ``psoas sign,'' defined as abdominal pain with passive right leg extension. Laboratory blood tests were remarkable for leukocytosis (15.9 K/mm3, ref 5-11) with neutrophilia, and an elevated C-reactive protein (19.8 mg/dL, ref <0.8).

Initial contrast-enhanced CT examination of the abdomen and pelvis (Fig. 1) was interpreted as a ``thick walled, 10 cm right lower quadrant/pelvis abscess,'' that was presumed secondary to a perforated appendicitis.

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