Department of Radiology, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, Japan.
Jpn J Radiol. 2014 May;32(5):296-301. doi: 10.1007/s11604-014-0302-4. Epub 2014 Mar 16.
We report a rare case of crystal-storing histiocytosis (CSH) associated with marginal-zone lymphoma. A 91-year-old woman with a history of breast cancer presented with masses of the posterior neck, right breast, and left upper arm. An enlarging mass of the neck was removed and was histologically diagnosed as CSH, associated with marginal-zone lymphoma. Masses in the breast and upper arm were evaluated by needle biopsy and revealed as CSH. CSH is a rare condition characterized by the intrahistiocytic accumulation of crystallized immunoglobulins, and is associated with disorders in which monoclonal immunoglobulins are expressed. To the best of our knowledge, there are few previous descriptions of CSH which include the imaging features of this disease. In the present case, the masses showed hypoechogenicity with internal patchy hyperechoic areas on ultrasonography, and an iso-signal to slight hyperintensity compared with muscle on T2-weighted magnetic resonance imaging. We report the imaging findings in CSH and discuss their diagnostic implications.
我们报告一例罕见的伴有边缘区淋巴瘤的晶体贮积性组织细胞增生症(CSH)。一名 91 岁的女性,有乳腺癌病史,出现后颈部、右乳房和左上臂肿块。切除了颈部增大的肿块,组织学诊断为 CSH,伴边缘区淋巴瘤。通过针吸活检评估乳房和上臂的肿块,结果显示为 CSH。CSH 是一种罕见疾病,其特征为组织细胞内结晶免疫球蛋白的蓄积,与单克隆免疫球蛋白表达的疾病有关。据我们所知,以前很少有描述 CSH 的病例包括该病的影像学特征。在本病例中,肿块在超声检查上呈低回声,内部呈斑片状高回声区,与 T2 加权磁共振成像上的肌肉相比呈等信号至轻度高信号。我们报告 CSH 的影像学表现,并讨论其诊断意义。