Etemadi J, Mortazavi-Khosrowshahi M, Ardalan M R, Esmaili H, Javadrashid R, Shoja M M
Department of Nephrology, Tabriz University of Medical Sciences, Tabriz, Iran.
Transplant Proc. 2009 Sep;41(7):2920-2. doi: 10.1016/j.transproceed.2009.07.040.
The brown tumor of hyperparathyroidism is histologically identical to the central giant cell granuloma (CGCG), but these lesions can be differentiated based on history and laboratory findings. Herein we have reported a 46-year-old renal transplant recipient in whom brown tumors of hyperparathyroidism were detected several years following renal transplantation. The lesions initially masqueraded as a CGCG with an intranasal mass and ethmoid bone involvement at 7-years posttransplantation, for which surgical resection had been performed. Six years later, she developed multiple expansile bony lesions of the chest wall with histologic features of multinucleated giant cells. A markedly elevated parathyroid hormone level led us to make a diagnosis of brown tumor of hyperparathyroidism. Hence, we propose that clinicians consider brown tumor of hyperparathyroidism to be a potential cause of giant cell lesions among renal transplant recipients. Moreover, careful follow-up examinations are required for such patients to make a timely and accurate diagnosis.
甲状旁腺功能亢进的棕色瘤在组织学上与中央巨细胞肉芽肿(CGCG)相同,但这些病变可根据病史和实验室检查结果进行鉴别。在此,我们报告了一名46岁的肾移植受者,在肾移植几年后发现了甲状旁腺功能亢进的棕色瘤。病变最初在移植后7年表现为CGCG,伴有鼻内肿物和筛骨受累,并进行了手术切除。6年后,她出现了具有多核巨细胞组织学特征的胸壁多处膨胀性骨病变。甲状旁腺激素水平显著升高使我们诊断为甲状旁腺功能亢进的棕色瘤。因此,我们建议临床医生将甲状旁腺功能亢进的棕色瘤视为肾移植受者巨细胞病变的潜在原因。此外,对此类患者需要进行仔细的随访检查,以便及时准确地做出诊断。