Ooi Chin Chin, Cheah Foong Koon, Wong Siew Kune
Department of Diagnostic Radiology, Singapore General Hospital, Block 2, Level 1, Outram Road, Singapore, 169608.
J Clin Ultrasound. 2015 Sep;43(7):438-42. doi: 10.1002/jcu.22192. Epub 2014 Jun 20.
We report a case of rare Castleman's disease of the kidney that mimicked a renal neoplasm with emphasis on the imaging and histologic findings. A 47-year-old man presented with dyspeptic symptoms. Ultrasound revealed a vascular, heterogeneous mass in the left kidney. Multiphasic CT scan confirmed an enhancing lesion with enlarged left para-aortic lymph nodes suspicious for nodal metastases. The provisional diagnosis was renal cell carcinoma. Percutaneous biopsy yielded a diagnosis of Castleman's disease of the hyaline-vascular type. Despite advancement in imaging modalities, differentiation of hyaline-vascular variant of Castleman's disease from hypervascular renal neoplasm remains difficult and the final diagnosis requires histopathological confirmation.
我们报告一例罕见的肾Castleman病,该病例酷似肾肿瘤,重点介绍其影像学和组织学表现。一名47岁男性出现消化不良症状。超声检查发现左肾有一个血管丰富的不均匀肿块。多期CT扫描证实有一个强化病灶,左主动脉旁淋巴结肿大,怀疑有淋巴结转移。初步诊断为肾细胞癌。经皮活检确诊为透明血管型Castleman病。尽管影像学检查手段不断进步,但Castleman病透明血管型与高血供肾肿瘤的鉴别仍很困难,最终诊断需要组织病理学证实。