The gastrointestinal tract is the most common extranodal site involved with lymphoma accounting for 5–20% of all cases. Lymphoma can occur at any site of the body, but diffuse and extensive involvement of the peritoneal cavity is unusual and rare. We report a case of diffuse large B-cell lymphoma in a 57-year-old female infiltrating the peritoneum and omentum and presenting with ascites and pleural effusion. The performed examinations did not discover any pathological findings affecting the digestive tract or parenchymal organs, except for diffuse thickening of the peritoneum and omentum. Peripheral, mediastinal, or retroperitoneal lymphadenopathy was not registered. The blood count revealed only elevated leukocytes and on examination there were no immature blood cells in the peripheral blood. The cytology from the ascites and pleural effusion did not detect any malignant cells. Due to the rapid disease progression the patient died after twenty-two days of admission. The diagnosis was discovered postmortem with the histological examination and immunohistochemical study of the material taken during the surgical laparoscopy performed four days before the lethal outcome. Although cytology is diagnostic in most cases, laparoscopy with peritoneal biopsy is the only procedure which can establish the definitive diagnosis of peritoneal lymphomatosis. 1. Introduction Extranodal lymphoma occurs in about 40% of all patients with lymphoma and has been described in virtually every organ and tissue [1]. Extranodal disease is more common with nonHodgkin’s lymphoma (NHL); it is often intermediate- to high-grade [2, 3] and the extranodal involvement is in general a poor prognostic factor [4]. Secondary involvement of extranodal tissue as part of generalized lymphoma is significantly more common than primary extranodal disease in which there is a dominant extranodal component with no or minor nodal involvement [4]. The gastrointestinal tract is the most common extranodal site involved with lymphoma accounting for 5–20% of all cases and a gastrointestinal involvement is usually secondary to widespread nodal disease [5]. Diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma are the dominant histological subtypes in extranodal lymphoma [4]. Although primary gastrointestinal lymphomas (PGLs) are relatively rare, they are still the most common type of primary extranodal lymphomas. PGL accounts for 40% of all extranodal NHLs, for 4%–20% of all NHL cases, and for about 1%–4% of all gastrointestinal malignancies [4, 6–9]. Almost 90% of the PGLs are of B cell lineage and
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