Owens Christopher L, Weir Edward G, Ali Syed Z
The Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland 21287, USA.
Diagn Cytopathol. 2007 Aug;35(8):512-5. doi: 10.1002/dc.20687.
A 34-year-old man with a history of a scorpion bite followed by increasing polyneuropathy and IgG lambda monoclonal gammopathy was referred for fine-needle aspiration of a lytic bone lesion and an enlarged axillary lymph node. The findings in the bone lesion were consistent with a plasmacytoma. The FNA of the lymph node showed a peculiar capillary proliferation in a background of polymorphous mature lymphocytes. Flow cytometric analysis showed a mixed lymphoid population. The lymph node was originally signed out descriptively, but review of the case showed features consistent with Castleman disease. After the pathologic findings and clinical features were discussed with the clinical team, the diagnosis of POEMS syndrome was established. Subsequent surgical excision of the lymph node was diagnosed as hyaline vascular-variant Castleman disease.
一名34岁男性，有蝎子蜇伤史，随后出现进行性多神经病和IgG λ单克隆丙种球蛋白病，因溶骨性骨病变和腋窝淋巴结肿大接受细针穿刺活检。骨病变的检查结果符合浆细胞瘤。淋巴结细针穿刺活检显示在多形性成熟淋巴细胞背景中有特殊的毛细血管增生。流式细胞术分析显示为混合性淋巴细胞群。该淋巴结最初按描述性诊断，但病例复查显示其特征符合Castleman病。与临床团队讨论病理结果和临床特征后，确诊为POEMS综合征。随后手术切除的淋巴结被诊断为透明血管型Castleman病。
