Lee Ki-Deok, Lee Keun-Wook, Choi In Sil, Yoon Sung-Soo, Park Seonyang, Kim Byoung Kook, Kim Noe Kyeong
Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-Dong, Chongno-Gu, 110-744, Seoul, South Korea.
Ann Hematol. 2004 Nov;83(11):722-5. doi: 10.1007/s00277-004-0923-2. Epub 2004 Aug 17.
We report a case of Castleman's disease that developed tumor lysis syndrome spontaneously and after systemic chemotherapy. A 44-year-old male patient was admitted with a 2-week history of abdominal distension accompanied by dyspnea. Physical examination revealed multiple lymph node enlargements. After admission, spontaneous hemoperitoneum developed and he underwent exploratory laparotomy, with the removal of the ruptured spleen. Pathologic review of the splenic tissue and excised lymph node gave the diagnosis of multicentric Castleman's disease. He experienced two episodes of tumor lysis syndrome, initially spontaneous and then chemotherapy related, which needed vigorous management including hemodialysis and intensive fluid therapies. To our knowledge, this is the first reported case of Castleman's disease complicated by tumor lysis syndrome. This suggests that the possibility of tumor lysis syndrome should be considered when treating Castleman's disease with a large disease burden.
我们报告一例Castleman病，该患者在全身化疗前后均自发发生肿瘤溶解综合征。一名44岁男性患者因腹胀伴呼吸困难2周入院。体格检查发现多处淋巴结肿大。入院后发生自发性血腹，随后接受了剖腹探查术，切除了破裂的脾脏。脾脏组织和切除淋巴结的病理检查确诊为多中心Castleman病。他经历了两次肿瘤溶解综合征发作，最初是自发的，随后与化疗相关，这需要积极的治疗，包括血液透析和强化液体治疗。据我们所知，这是首例报告的Castleman病合并肿瘤溶解综合征的病例。这表明，在治疗疾病负担较大的Castleman病时，应考虑肿瘤溶解综合征的可能性。
