Answer to Q2

Pseudomyxoma peritonei

The CT image shows evidence of gross ascites, scalloped liver margin (Whit arrow) . Ascites could result from a number of reasons including tuberculosis, peritoneal carcinomatosis, chronic liver disease amongst others. Scalloping of visceral organs is typical for pseudomyxoma peritonei and can also be seen in peritoneal carcinomatosis. Scalloping has occasionaly also been reported with periotneal tuberculosis. The CT also shows a calcified mural thickening of a descending colonic loop (black arrow). Colonoscopy and ascitic fluid analysis confirmed the diagnosis of a mucinous colonic adenocarcinoma with pseudomyxoma peritonei

References

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Xiang H, Han J, Ridley WE, Ridley LJ. Scalloping of the liver: Pseudomyxoma peritonei. J Med Imaging Radiat Oncol. 2018 Oct;62 Suppl 1:103.

Allart K, Sabbagh C, Regimbeau JM. Liver scalloping: Pseudomyxoma peritonei liver compression. J Visc Surg. 2018 Dec 3. pii: S18787886(18)30127-9.

Rodríguez E, Pombo F. Peritoneal tuberculosis versus peritoneal carcinomatosis: distinction based on CT findings. J Comput Assist Tomogr 1996; 20: 269–272. [PubMed]

Charoensak A, Nantavithya P, Apisarnthanarak P. Abdominal CT findings to distinguish between tuberculous peritonitis and peritoneal carcinomatosis. J Med Assoc Thai 2012; 95: 1449–1456.