PMC10205527_01
Abdominal scan showing irregular thickening of the parietal peritoneum (white arrow), there is also a significant amount of ascitic fluid.
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However, an abdominal computed tomography (CT) scan revealed thickening of the parametrium, parietal peritoneum, omentum, gastric cavity, intestinal lining, and intraperitoneal liquid with intermediate density in all compartments (Fig. 1).
The interior of the abdominal cavity can be seen during laparoscopy with parietal peritoneum in which innumerable micronodular lesions give the appearance of a miliary pattern (black circle).
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On the fourth day of hospitalization, a diagnostic laparoscopy revealed a friable peritoneum with numerous miliary-like micronodules covering the entire peritoneal and pelvic cavity (Fig. 2).
A, B, C. H&E stain showing fibroconnective tissue with the presence of multiple granulomas with a crown of lymphocytes, epithelioid cells, and multinucleated giant cells, necrotic center. D, E, F. H&E staining at higher magnification shows chronic granulomatous inflammation, granulomas with necrosis, multinucleated cells, and epithelioid cells.
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Three days later, the pathology report revealed fibroconnective tissue with multiple confluent granulomas, high histiocytic cellularity and multinucleated giant cells surrounded by a lymphoplasmacytic inflammatory infiltrate, some of which contained central necrosis (Fig. 3).