Differential Diagnosis for Omental Thickening with Nodularity
Single Most Likely Diagnosis
- Metastatic Disease: Omental thickening with nodularity is often seen in metastatic cancer, particularly from gastrointestinal, breast, or ovarian primaries. The omentum's high concentration of lymphatic vessels makes it a common site for metastasis.
Other Likely Diagnoses
- Peritoneal Carcinomatosis: Similar to metastatic disease, primary peritoneal carcinomatosis can cause omental thickening and nodularity due to the spread of cancer cells throughout the peritoneal cavity.
- Tuberculosis: Abdominal tuberculosis can cause omental thickening and nodularity, especially in endemic areas or in immunocompromised patients.
- Sarcoidosis: This systemic granulomatous disease can involve the omentum, leading to thickening and nodularity, although it is less common than other manifestations like pulmonary or lymph node involvement.
Do Not Miss Diagnoses
- Lymphoma: Both primary and secondary lymphoma of the omentum can present with thickening and nodularity. Missing this diagnosis could lead to delayed treatment of a potentially curable disease.
- Intra-abdominal Infections: Certain infections, such as abscesses or peritonitis, can cause omental thickening. While less likely to present with nodularity, these conditions require prompt diagnosis and treatment to prevent severe complications.
Rare Diagnoses
- Whipple's Disease: A rare, systemic bacterial infection that can cause malabsorption and may involve the omentum, leading to thickening and nodularity.
- Castleman Disease: A rare lymphoproliferative disorder that can involve the omentum and present with nodularity, among other systemic symptoms.
- Omental Torso: A rare condition where the omentum becomes twisted, leading to ischemia and potentially causing thickening and nodularity, although this is more of an acute condition rather than a chronic process.