Sato Takashi, Sugiyama Takeshi, Kawataki Tomoyuki, Sato Eiji, Horikoshi Toru, Sugita Kanji, Kinouchi Hiroyuki
Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan.
J Neurosurg Pediatr. 2010 Jun;5(6):622-5. doi: 10.3171/2010.1.PEDS09413.
This 11-year-old boy presented with a rare case of Castleman syndrome caused by a clear cell meningioma manifesting as persistent fever of unknown origin, 2 years after glomerulonephritis. Laboratory investigation of the patient showed an increased inflammatory reaction, as well as elevated polyclonal gamma globulin titer and serum level of C-reactive protein. Magnetic resonance imaging revealed a tumor at the cerebellopontine angle. Neurosurgical intervention was performed under the presumptive diagnosis of Castleman syndrome caused by intracranial tumor. Histological examination of the tumor verified that it was clear cell meningioma with infiltration of lymphoplasma cells, and surgical removal resulted in complete resolution of the patient's symptoms and biochemical abnormalities. The present case of clear cell meningioma manifesting as Castleman syndrome shows that the possibility of a brain tumor should be considered in patients presenting with fever of unknown origin, anemia, hypergammaglobulinemia, or other systemic illness.
这名11岁男孩患有一种罕见的Castleman综合征，由透明细胞脑膜瘤引起，表现为不明原因的持续发热，发生在肾小球肾炎2年后。对该患者的实验室检查显示炎症反应增强，以及多克隆γ球蛋白滴度和血清C反应蛋白水平升高。磁共振成像显示桥小脑角有一个肿瘤。在颅内肿瘤导致Castleman综合征的推测诊断下进行了神经外科干预。肿瘤的组织学检查证实为伴有淋巴浆细胞浸润的透明细胞脑膜瘤，手术切除使患者的症状和生化异常完全缓解。本例表现为Castleman综合征的透明细胞脑膜瘤表明，对于出现不明原因发热、贫血、高球蛋白血症或其他全身性疾病的患者，应考虑脑肿瘤的可能性。
