Diagnostic Dilemma

Lump in abdomen

An 11 years old girl hailing from Bihar, presented with pain in abdomen for 1½ months. There was no jaundice or fever. She has received blood transfusion for same and was started on 3 drugs antituberculous therapy {ATT} in view of CT abdomen showing hepatomegaly with periportal lymphnodes with dilated portal vein and thrombosed left branch but had no response. Her hemogram was normal, liver and renal function tests were also normal. ESR was 62 mm at end of 1 hour and Mantoux test, HIV were negative, and chest X-Ray was normal. On examination, weight was 20.2 kg, left lobe of liver was palpable 6 cm and was hard, and she had anasarca. Other systems were normal.

What is the likely diagnosis_?
Expert Opinion :
She was suspected to have malignancy or an autoimmune disease. Her USG abdomen showed a tumor invading left lobe of liver and bowels. Her repeat CBC showed pancytopenia. ANA, dsDNA were negative. Kala-azar Antigen test was negative. Subsequently she was advised bone marrow examination, but she took discharge against medical advice.
Answer Discussion :
Chuka Udokwu
Chronic myeloid leukaemia
8 years ago
rizwan khan
portal vein thrombosis
8 years ago

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