Peritoneal disease: key imaging findings that help in the differential diagnosis

Br J Radiol. 2022 Feb 1;95(1130):20210346. doi: 10.1259/bjr.20210346. Epub 2021 Nov 23.


The peritoneum is a unique serosal membrane, which can be the site of primary tumors and, more commonly, secondary pathologic processes. Peritoneal carcinomatosis is the most common malignant condition to affect the peritoneal cavity, and the radiologist plays an important role in making the diagnosis and assessing the extent of disease, especially in sites that may hinder surgery. In this review, we address the role of the radiologist in the setting of peritoneal pathology, focusing on peritoneal carcinomatosis as this is the predominant malignant process, followed by revising typical imaging findings that can guide the differential diagnosis.We review the most frequent primary and secondary peritoneal tumor and tumor-like lesions, proposing a systemic approach based on clinical history and morphological appearance, namely distinguishing predominantly cystic from solid lesions, both solitary and multiple.

Publication types

  • Review

MeSH terms

  • Ascites / diagnostic imaging
  • Ascitic Fluid / physiology
  • Carcinoma / diagnostic imaging
  • Desmoplastic Small Round Cell Tumor / diagnostic imaging
  • Diagnosis, Differential
  • Echinococcosis / diagnostic imaging
  • Endometriosis / diagnostic imaging
  • Female
  • Humans
  • Lymphangioma / diagnostic imaging
  • Lymphoma / diagnostic imaging
  • Magnetic Resonance Imaging
  • Mesothelioma / diagnostic imaging
  • Neoplasms, Neuroepithelial / diagnostic imaging
  • Peritoneal Neoplasms / diagnostic imaging*
  • Peritoneal Neoplasms / pathology
  • Peritoneal Neoplasms / secondary
  • Peritoneum / anatomy & histology
  • Peritonitis / diagnostic imaging
  • Positron Emission Tomography Computed Tomography
  • Pseudomyxoma Peritonei / diagnostic imaging
  • Splenosis / diagnostic imaging
  • Tomography, X-Ray Computed