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全髋关节置换术后盆腔淋巴结炎:一名前列腺癌患者中类似淋巴结转移的情况

[Pelvic lymphadenitis after total hip arthroplasty : Mimicking of lymph node metastases in a patient with prostate cancer].

作者信息

Sevinc S, Westhoff C C, Schrader A J, Olbert P J, Hofmann R, Hegele A

机构信息

Klinik für Urologie und Kinderurologie, Universitätsklinikum Giessen und Marburg GmbH, Standort Marburg, Baldingerstrasse, 35043, Marburg, Deutschland.

出版信息

Urologe A. 2010 Aug;49(8):952-6. doi: 10.1007/s00120-009-2212-0.

Abstract

This report describes the case of a 65-year-old patient who underwent radical prostatectomy in our department. Intraoperatively we detected suspicious lymph nodes on the left side. The histopathological examination revealed histiocytosis and foreign body giant cells but no sign of tumor. The enlarged lymph nodes were ascribed to an ipsilateral total hip arthroplasty performed 14 years previously because of progressive coxarthrosis. Lymphadenitis after total hip arthroplasty is frequently observed. Histopathologically and with the use of polarized light microscopy, histiocytosis and wear particles such as titanium, polyethylene, and polyethylene-methylacrylate may be detected. When operating on patients with arthroplasty of a lower limb, particularly those with a total endoprosthesis, the surgeon should bear in mind that changes in lymph node consistency and size do not necessarily indicate tumor involvement or metastases.

摘要

本报告描述了一名65岁患者在我科接受根治性前列腺切除术的病例。术中我们在左侧发现可疑淋巴结。组织病理学检查显示组织细胞增多症和异物巨细胞,但无肿瘤迹象。肿大的淋巴结归因于14年前因进行性髋关节病而行的同侧全髋关节置换术。全髋关节置换术后的淋巴结炎很常见。在组织病理学上,通过偏振光显微镜检查,可检测到组织细胞增多症以及钛、聚乙烯和聚甲基丙烯酸甲酯等磨损颗粒。在对下肢关节置换术患者,尤其是全内置假体患者进行手术时,外科医生应牢记,淋巴结质地和大小的改变不一定表明肿瘤累及或转移。

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